MORELAND MEDICAL LABORATORY, LLC (NPI# 1184022360) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184022360 |
| Entity Type | Organization |
| Organization Name | MORELAND MEDICAL LABORATORY, LLC |
| Other Organization Name | MORELAND MEDICAL LABORATORY |
| Practice Address |
1111 Delafield St Suite 301 Waukesha WI 53188-3417 |
| Practice Telephone | 8883170769 |
| Practice Fax Number | 8883170769 |
| Mailing Telephone | 8883170769 |
| Mailing Fax Number | 8883170769 |
| Enumeration Date | 2014-12-20 |
| Last Update Date | 2015-09-18 |
| Authorized Official Name | HENRY RANDOLPH HOPKINSON (MEMBER) |
| Authorized Official Telephone | 3215144992 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | Laboratories |
| Other Name | Type Code |
|---|---|
| Moreland Medical Laboratory | Doing Business As Name - Organization |
| Street Address |
1111 DELAFIELD ST SUITE 301 |
| City | WAUKESHA |
| State | WI |
| Zip Code | 53188-3417 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346240959 | W. Patrick Flanagan Jr. | Urology | 1111 Delafield St, Suite 12, Waukesha, WI 53188-3417 | 2005-07-26 |
| 1154839140 | Sandra Koester | Orthopaedic Surgery | 1111 Delafield St, Waukesha, WI 53188 | 2018-01-12 |
| 1467975383 | Deanne Evelyn Dunder | Nurse Practitioner | 1111 Delafield St, Waukesha, WI 53188-3417 | 2017-07-23 |
| 1255868006 | Ryan J Moncada | Physician Assistant | 1111 Delafield St, Suite 207, Waukesha, WI 53188-3417 | 2017-05-11 |
| 1235672239 | Paul B Doenier Md, Sc | Family Medicine | 1111 Delafield St, Suite 321, Waukesha, WI 53188-3417 | 2016-11-22 |
| 1013395078 | Alyssa Kathryn Eisner | Physician Assistant | 1111 Delafield St, Suite 209, Waukesha, WI 53188-3403 | 2015-05-11 |
| 1679950513 | Holly Beth Maciejewski | Nurse Practitioner | 1111 Delafield St, 215, Waukesha, WI 53188-3417 | 2015-04-29 |
| 1710395959 | Orthopedic Associates of Wisconsin | Clinic/Center | 1111 Delafield St, Waukesha, WI 53188-3417 | 2014-07-31 |
| 1053729046 | Debra Seiler | Nurse Practitioner | 1111 Delafield St, Suite 215, Waukesha, WI 53188-3417 | 2014-07-23 |
| 1215341920 | Lauren Wagner Wile | Physician Assistant | 1111 Delafield St, Waukesha, WI 53188-3417 | 2014-06-20 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336787126 | Nicole Lee Berg-johnson | Nurse Practitioner | 820 Crestwood Dr., Waukesha, WI 53188 | 2019-12-12 |
| 1013475706 | Rachel Mueller | Occupational Therapist | 29667 Summit Ave, S11, Waukesha, WI 53188 | 2019-03-12 |
| 1861962649 | Emily Elizabeth Seefeld | Occupational Therapy Assistant | 29667 Summit Ave S11, Waukesha, WI 53188 | 2018-12-05 |
| 1003393307 | Ashley Susan Callahan | Dental Hygienist | 711 W. Moreland Blvd., Suite 204, Waukesha, WI 53188 | 2018-07-19 |
| 1245741321 | Melissa Weir | Case Manager/Care Coordinator | 514 Riverview Avenue, Waukesha, WI 53188 | 2017-10-17 |
| 1093233629 | Patricia Marie Sombrio | Dental Hygienist | 711 Moreland Blvd 204, Waukesha, WI 53188 | 2017-09-04 |
| 1134660244 | Bdg of Wisconsin, Inc. | Behavioral Analyst | N19w2309 Riverwood Drive, Suite 350 Pmb 314, Waukesha, WI 53188 | 2017-03-09 |
| 1255888731 | Lynne Sarah Alva | Dental Hygienist | 711 Moreland Blvd, Suite 204, Waukesha, WI 53188 | 2016-09-01 |
| 1881069730 | Michelle Koch | Occupational Therapist | 29667 Summit Ave. S11, Waukesha, WI 53188 | 2015-12-03 |
| 1952711012 | Rhonda Schroeder | Dental Hygienist | W286 N991 Shepherds Way, Waukesha, WI 53188 | 2014-04-29 |
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| Taxonomy Code | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831619535 | Laboratory Corporation of America | Clinical Medical Laboratory | 1111 Delafield St Ste 301, Waukesha, WI 53188-3407 | 2017-06-23 |
| 1326200338 | Coppe Healthcare Solutions | Clinical Medical Laboratory | W229 N1870 Westwood Dr, Waukesha, WI 53186 | 2008-06-30 |
| 1598985350 | Prodesse, Inc. | Clinical Medical Laboratory | W229n1870 Westwood Dr, Waukesha, WI 53186-1302 | 2007-04-26 |
| 1174762264 | Professional Clinical Laboratory, LLC | Clinical Medical Laboratory | 1111 Delafield St, Suite 309, Waukesha, WI 53188-3417 | 2009-02-12 |
| 1447248182 | Moreland Medical Center | Clinical Medical Laboratory | 1111 Delafield St, Suite 301, Waukesha, WI 53188-3417 | 2005-10-06 |
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| 1881238269 | Derek Raymond Schindler | Clinical Medical Laboratory | 680 Baker Rd, Hudson, WI 54016-7901 | 2019-10-29 |
| 1487296307 | Exact Sciences Laboratories, LLC | Clinical Medical Laboratory | 650 Forward Drive, Madison, WI 53711 | 2019-10-11 |
| 1003391269 | Precise Testing LLC | Clinical Medical Laboratory | 6815 W Capitol Dr Ste 105, Milwaukee, WI 53216-2056 | 2018-10-03 |
| 1992286074 | Rprd Diagnostics LLC | Clinical Medical Laboratory | 1225 Discovery Parkway, Suite 260, Milwaukee, WI 53226 | 2018-08-27 |
| 1164938916 | Tai Diagnostics, Inc. | Clinical Medical Laboratory | 10101 W Innovation Dr Ste 600, Wauwatosa, WI 53226-4824 | 2017-12-15 |
| 1558896498 | Noah Associates Incorporated | Clinical Medical Laboratory | 10501 W Greenfield Ave, West Allis, WI 53214-2421 | 2017-04-28 |
| 1972952851 | Lab Affinity LLC | Clinical Medical Laboratory | 2119 W Juneau Ave, Milwaukee, WI 53233-1118 | 2016-06-10 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.