Healthcare Provider Details

I. General information

NPI: 1174692628
Provider Name (Legal Business Name): LABCO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/07/2006
Last Update Date: 09/14/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

222 LAWRENCE AVE
PARK FALLS WI
54552-1431
US

IV. Provider business mailing address

222 LAWRENCE AVE
PARK FALLS WI
54552-1431
US

V. Phone/Fax

Practice location:
  • Phone: 715-762-2975
  • Fax:
Mailing address:
  • Phone: 715-762-2975
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: SHARON K SCHULTZ
Title or Position: PRESIDENT
Credential:
Phone: 715-762-2449