Provider Demographics
NPI:1003391269
Name:PRECISE TESTING LLC
Entity Type:Organization
Organization Name:PRECISE TESTING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:REGINALD
Authorized Official - Middle Name:T
Authorized Official - Last Name:BIRT
Authorized Official - Suffix:
Authorized Official - Credentials:MBA, LCSW
Authorized Official - Phone:414-331-9055
Mailing Address - Street 1:6815 W CAPITOL DR STE 105
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53216-2056
Mailing Address - Country:US
Mailing Address - Phone:414-210-5855
Mailing Address - Fax:
Practice Address - Street 1:6815 W CAPITOL DR STE 105
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53216-2056
Practice Address - Country:US
Practice Address - Phone:414-210-5855
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-03
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory