MARTAVIA STANFORD LABORATORY DIRECTOR NPI 1548985930

NPI Information

NPI: 1548985930
Provider Name: MARTAVIA STANFORD, LABORATORY DIRECTOR
Classification: Pathology - 247ZC0005X
Entity Type: Individual

Specialization: Clinical Laboratory Director, Non-physician

Address:
120 BISHOPS WAY STE 165
BROOKFIELD, WI
ZIP 53005
Phone: (414) 355-5525
Get Directions

Martavia Stanford, LABORATORY DIRECTOR is a clinical laboratory director and non-physician pathology in Brookfield, WI. The provider is an individual who is state-licensed as a clinical laboratory director and meets the qualifications in the Clinical Laboratory Improvement Amendments of 1988 for non-physicians (non-MD/DO) as defined in the CFR 42 Part 493.1405. Martavia Stanford, LABORATORY DIRECTOR NPI is 1548985930. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

120 BISHOPS WAY STE 165
BROOKFIELD, WI
ZIP 53005-249
Phone: (414) 355-5525
Fax: (414) 240-4595

The enumeration date for this NPI number is 10/7/2022 and was last updated on 10/7/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YP1600X	Counselor	Pastoral			No
2	372600000X	Adult Companion				No
3	374U00000X	Home Health Aide				No
4	376J00000X	Homemaker				No
5	247ZC0005X	Pathology	Clinical Laboratory Director, Non-physician	52D2261520	WISCONSIN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	52D2261520	OTHER	WISCONSIN	CLIA STATE OF WISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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