MEDICARE: LABWORKS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	291U00000X	Clinical Medical Laboratory	52D1031844	WI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	000083205	OTHER	WI	MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891822771
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LABWORKS, LLC

Provider Business Mailing Address
First Line	:	PO BOX 639
Second Line	:
City	:	THIENSVILLE
State	:	WI
Zip	:	53092-0639
Country	:	US
Telephone Number	:	414-247-9005
Fax Number	:	414-247-9004

Provider Business Practice Location Address
First Line	:	1630 B MILLER PARK WAY
Second Line	:
City	:	WEST MILWAUKEE
State	:	WI
Zip	:	53214-3604
Country	:	US
Telephone Number	:	414-248-3601
Fax Number	:	414-447-9891

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. BRYAN OBOYLE
Credential	:
Telephone Number	:	414-248-3601

Provider Enumeration Date	:	02/27/2007
Last Update Date	:	11/01/2016

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Directions to “LABWORKS, LLC ” Practice Location

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