Sage Prairie Laboratory
Specialist/Technologist, Other in Eagan, MN. Organization (NPI-2).
NPI number1164089447
StatusActive
Last updated in NPPESMay 22, 2019
Details
- NPI
- 1164089447
- Entity type
- Organization (NPI-2)
- Legal business name
- Sage Prairie Laboratory
- Organization subpart
- Yes
- Enumeration date
- May 22, 2019
- Last updated
- May 22, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 246Z00000X | Specialist/Technologist, Other | – | – | Yes |
Other names
- Sage Prairie Laboratory (Doing Business As)
Practice location
1440 Duckwood DrEagan, MN 55122-1451
Phone 651-238-5558 · Fax 612-437-4992
Mailing address
1440 Duckwood Dr Ste 100Eagan, MN 55122-1451
Phone 651-238-5558 · Fax 612-437-4992
Authorized official
Grant Arnold Pylkas
Executive Director
6512385558
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