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General NPI Number Information
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NPI Number | 1043854144
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Entity Type | Organization
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Legal Business Name | STEMINA BIOMARKER DISCOVERY, INC.
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Dates
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Enumeration Date | 10/31/2019
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Last Update Date | 10/31/2019
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Provider Practice Location Address
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Address Line | 504 S ROSA RD STE 150
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City | MADISON
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State | WI
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Zip | 53719-1218
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Country | US
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Telephone | 608-204-0104
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Fax | 608-204-0107
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Provider Business Mailing Address
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Address Line | 504 S ROSA RD STE 150
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City | MADISON
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State | WI
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Zip | 53719-1218
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Country | US
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Telephone | 608-204-0104
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Fax | 608-204-0107
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MS. ELIZABETH DONLEY
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Credential | JD, MBA, MS
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Telephone | 608-577-9209
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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