Healthcare Provider Details
I. General information
NPI: 1043142276
Provider Name (Legal Business Name): INSTANT DRAW LABORATORY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8531 W DOUGLAS AVE
MILWAUKEE WI
53225-1917
US
IV. Provider business mailing address
8531 W DOUGLAS AVE
MILWAUKEE WI
53225-1917
US
V. Phone/Fax
- Phone: 262-595-7998
- Fax:
- Phone: 262-595-7998
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 246RP1900X |
| Taxonomy | Phlebotomy Technician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 291U00000X |
| Taxonomy | Clinical Medical Laboratory |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 293D00000X |
| Taxonomy | Physiological Laboratory |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SIDNEY
L
SMITH
Title or Position: OWNER/PHLEBOTOMIST
Credential:
Phone: 262-595-7998