GREEN LAKE MEDICAL CLINIC
NPI 1316087885
Clinical Medical Laboratory in Green Lake, WI

Active since February 07, 2007
N6205 BUSSE DRIVE, GREEN LAKE, WI 54941(920) 294-3444(920) 294-6660 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Green Lake Medical Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GREEN LAKE MEDICAL CLINIC (NPI 1316087885) is a healthcare organization registered as a clinical medical laboratory in Green Lake, Wisconsin and active in the NPI registry since February 2007. The organization lists Thomas Rice Willett, President, as its authorized official.

NPPES Registry Identity

NPI1316087885
Entity TypeOrganization
Primary Taxonomy291U00000X
Legal Business NameGREEN LAKE MEDICAL CLINIC
Location AddressN6205 BUSSE DRIVEGreen Lake, WI 54941-0429
Mailing AddressPo Box 429, N6205 Busse DriveGreen Lake, WI 54941-0429 · (920) 294-3444 · Fax (920) 294-6660
Fax(920) 294-6660
Organization SubpartNo
Authorized OfficialThomas Rice WillettPresident · (920) 294-3444
Enumeration DateFebruary 7, 2007
Last NPPES UpdateAugust 22, 2020
NPI 1316087885 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinical Medical LaboratoryLaboratories
Taxonomy Code291U00000X
License Licensed in WI · 17659
Definition
(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.
N6205 BUSSE DRIVE, Green Lake, WI 54941

Other Identifiers 1

Medicaid30071600WI

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Family Medicine
N6205 BUSSE DRIVE
GREEN LAKE, WI 54941

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Green Lake Medical Clinic's NPI number?

The NPI number for Green Lake Medical Clinic is 1316087885. It was assigned to this organization in the NPPES registry on February 7, 2007.

Where is Green Lake Medical Clinic located?

Green Lake Medical Clinic is located at N6205 Busse Drive, Green Lake, WI 54941. The listed phone number is (920) 294-3444.

What is Green Lake Medical Clinic's specialty?

The primary specialty registered for this NPI is Clinical Medical Laboratory with taxonomy code 291U00000X.

When was this NPI record last updated?

The NPPES record for Green Lake Medical Clinic was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.