Provider Demographics
NPI:1871244699
Name:MKE CLIA SOLUTIONS
Entity type:Organization
Organization Name:MKE CLIA SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:FELICIA
Authorized Official - Middle Name:LATORIA
Authorized Official - Last Name:ALSTORK
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:414-885-3709
Mailing Address - Street 1:4911 W GOOD HOPE RD STE 103
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53223-4840
Mailing Address - Country:US
Mailing Address - Phone:414-885-3709
Mailing Address - Fax:414-306-6426
Practice Address - Street 1:4911 W GOOD HOPE RD STE 103
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53223-4840
Practice Address - Country:US
Practice Address - Phone:414-885-3709
Practice Address - Fax:414-306-6426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-13
Last Update Date:2022-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No291U00000XLaboratoriesClinical Medical Laboratory