JACKSON LAB SERVICES LLC
NPI 1659149839
Point of Service in Milwaukee, WI
About Jackson Lab Services Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JACKSON LAB SERVICES LLC (NPI 1659149839) is a healthcare organization registered as a point of service in Milwaukee, Wisconsin and active in the NPI registry since December 2023. The organization holds a CLIA Waiver certificate valid through February 26, 2028 and lists Gemontasia Jackson, Director, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 52D2299818
Jackson Lab Services LLC · Milwaukee, WIOther Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Jackson Lab Services LLC's NPI number?
The NPI number for Jackson Lab Services LLC is 1659149839. It was assigned to this organization in the NPPES registry on December 18, 2023.
Where is Jackson Lab Services LLC located?
Jackson Lab Services LLC is located at 2872 N 59th St, Milwaukee, WI 53210. The listed phone number is (414) 939-5802.
What is Jackson Lab Services LLC's specialty?
The primary specialty registered for this NPI is Point of Service with taxonomy code 305S00000X.
Does Jackson Lab Services LLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 52D2299818) is associated with this NPI, valid through February 26, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Jackson Lab Services LLC was last updated on July 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.
# Jackson Lab Services Llc · NPI 1659149839
Point of Service organization in Milwaukee, Wisconsin. Organization record, active in the CMS NPPES registry since December 18, 2023.
## Identity
- **NPI:** 1659149839 (Entity type: Organization)
- **Enumerated:** December 18, 2023
- **Primary specialty:** Point of Service · taxonomy 305S00000X
- **Also known as:** Jackson Lab services LLC (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Gemontasia Jackson, DIRECTOR
## Practice location
- **Address:** 2872 N 59TH ST, Milwaukee, WI 53210-1504
- **Phone:** (414) 939-5802
## Record status
- **NPPES last updated:** July 18, 2025
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1659149839) · Data from the CMS NPPES public registry.