=====================================================
General NPI Number Information
=====================================================
NPI Number | 1083249577
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MAYO CLINIC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/05/2020
-----------------------------------------------------
Last Update Date | 08/15/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 200 1ST ST SW
-----------------------------------------------------
City | ROCHESTER
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55905-0002
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 507-284-2511
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 200 1ST ST SW
-----------------------------------------------------
City | ROCHESTER
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55905-0002
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 507-284-2511
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CFO
-----------------------------------------------------
Name | DENNIS EUGENE DAHLEN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 507-538-3389
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 291U00000X
-----------------------------------------------------
Taxonomy Name | Clinical Medical Laboratory
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------