Healthcare Provider Details

I. General information

NPI: 1316917008
Provider Name (Legal Business Name): ASSOCIATES IN PATHOLOGY, S.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2006
Last Update Date: 04/03/2025
Certification Date: 04/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 PINE RIDGE BLVD STE 200
WAUSAU WI
54401-4123
US

IV. Provider business mailing address

425 PINE RIDGE BLVD STE 200
WAUSAU WI
54401-4123
US

V. Phone/Fax

Practice location:
  • Phone: 715-847-0075
  • Fax: 715-847-0065
Mailing address:
  • Phone: 715-847-0075
  • Fax: 715-847-0065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number
License Number State

VIII. Authorized Official

Name: LEANN LANG
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 715-847-0075