Provider Information for 1093792350
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MAYO COLLABORATIVE SERVICES, INC
Other Names:Doing Business As:MAYO CLINIC LABORATORIESFormer Legal Business Name:MAYO COLLABORATIVE SERVICES, LLCOrganization Subpart: NO
NPI: 1093792350
Last Updated: 2023-12-13
Certification Date: 2023-12-12
Certification Date: 2023-12-12
Details
Name | Value | ||||||||
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NPI | 1093792350 | ||||||||
Enumeration Date | 2005-12-28 | ||||||||
NPI Type | NPI-2 Organization | ||||||||
Status | Active | ||||||||
Authorized Official Information | Name: BRIAN MEADE Title: Chief Operating Officer Phone: 5072663081 | ||||||||
Mailing Address | PO BOX 4100 ROCHESTER, MN 55903-4100 United States Phone: 800-447-6424 | Fax:800-524-5125 | ||||||||
Primary Practice Address | 200 1ST ST SW ROCHESTER, MN 55905-0002 United States Phone: 800-447-6424 | Fax:800-524-5125 | ||||||||
Secondary Practice Address(es) | 3050 SUPERIOR DR NW 4500 SAN PABLO RD S | ||||||||
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