Provider Demographics
NPI:1821482860
Name:SPECIALITY SCREENING LLC
Entity Type:Organization
Organization Name:SPECIALITY SCREENING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:CLEVELAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-539-1194
Mailing Address - Street 1:10111 W CAPITOL DR
Mailing Address - Street 2:SUITE 3
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53222-1335
Mailing Address - Country:US
Mailing Address - Phone:773-426-5060
Mailing Address - Fax:773-353-1668
Practice Address - Street 1:10111 W CAPITOL DR
Practice Address - Street 2:SUITE 3
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53222-1335
Practice Address - Country:US
Practice Address - Phone:773-426-5060
Practice Address - Fax:773-353-1668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-27
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory