Provider Demographics
NPI:1083346118
Name:ANA LAB LLC
Entity Type:Organization
Organization Name:ANA LAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COS
Authorized Official - Prefix:
Authorized Official - First Name:ANETA
Authorized Official - Middle Name:M
Authorized Official - Last Name:BIZEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-987-0775
Mailing Address - Street 1:1611 COUNTY ROAD B W STE 102
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55113-4053
Mailing Address - Country:US
Mailing Address - Phone:888-648-7652
Mailing Address - Fax:651-348-8349
Practice Address - Street 1:1611 COUNTY ROAD B W STE 102
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55113-4053
Practice Address - Country:US
Practice Address - Phone:888-648-7652
Practice Address - Fax:651-348-8349
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-28
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory