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General NPI Number Information
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NPI Number | 1821482860
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Entity Type | Organization
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Legal Business Name | SPECIALITY SCREENING LLC
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Dates
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Enumeration Date | 03/27/2015
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Last Update Date | 05/21/2021
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Provider Practice Location Address
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Address Line | 10111 W CAPITOL DR SUITE 3
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City | WAUWATOSA
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State | WI
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Zip | 53222-1335
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Country | US
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Telephone | 773-426-5060
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Fax | 773-353-1668
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Provider Business Mailing Address
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Address Line | 10111 W CAPITOL DR SUITE 3
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City | WAUWATOSA
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State | WI
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Zip | 53222-1335
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Country | US
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Telephone | 773-426-5060
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Fax | 773-353-1668
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Authorized Official
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Title or Position | CEO
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Name | ANN CLEVELAND
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Credential |
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Telephone | 205-539-1194
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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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