Provider Demographics
NPI:1851365209
Name:DANE COUNTY CYTOLOGY CENTER, INC
Entity Type:Organization
Organization Name:DANE COUNTY CYTOLOGY CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:A
Authorized Official - Last Name:KLEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-255-5135
Mailing Address - Street 1:2000 ENGEL ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MONONA
Mailing Address - State:WI
Mailing Address - Zip Code:53713-4822
Mailing Address - Country:US
Mailing Address - Phone:608-255-5135
Mailing Address - Fax:608-255-2640
Practice Address - Street 1:2000 ENGEL ST
Practice Address - Street 2:SUITE 201
Practice Address - City:MONONA
Practice Address - State:WI
Practice Address - Zip Code:53713-4822
Practice Address - Country:US
Practice Address - Phone:608-255-5135
Practice Address - Fax:608-255-2640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI32908500Medicaid
IL=========001Medicaid