Provider Demographics
NPI:1487296307
Name:EXACT SCIENCES LABORATORIES, LLC
Entity type:Organization
Organization Name:EXACT SCIENCES LABORATORIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:STACEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-284-5700
Mailing Address - Street 1:1 EXACT LN
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53711-9106
Mailing Address - Country:US
Mailing Address - Phone:608-284-5700
Mailing Address - Fax:608-535-8715
Practice Address - Street 1:650 FORWARD DRIVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53711
Practice Address - Country:US
Practice Address - Phone:608-284-5700
Practice Address - Fax:608-535-8715
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EXACT SCIENCES LABORATORIES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-10-11
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1629407069Medicaid