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General NPI Number Information
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NPI Number | 1083346118
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Entity Type | Organization
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Legal Business Name | ANA LAB LLC
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Dates
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Enumeration Date | 06/28/2022
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Last Update Date | 06/28/2022
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Provider Practice Location Address
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Address Line | 1611 COUNTY ROAD B W STE 102
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City | ROSEVILLE
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State | MN
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Zip | 55113-4053
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Country | US
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Telephone | 888-648-7652
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Fax | 651-348-8349
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Provider Business Mailing Address
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Address Line | 1611 COUNTY ROAD B W STE 102
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City | ROSEVILLE
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State | MN
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Zip | 55113-4053
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Country | US
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Telephone | 888-648-7652
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Fax | 651-348-8349
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Authorized Official
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Title or Position | COS
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Name | ANETA M BIZEK
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Credential |
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Telephone | 612-987-0775
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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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