Individual provider · Type 1 NPI
Dennis Dietzen
Clinical Laboratory Director (Non-physician) · Glen Carbon, IL
NPI number
1598475592
Active
Practice location
203 Sierra Pt
Glen Carbon, IL 62034-1346
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Clinical Laboratory Director (Non-physician) Primary | 247ZC0005X | None listed |
Clinical Laboratory Director (Non-physician): 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.
About NPI 1598475592
Dennis Dietzen's National Provider Identifier is 1598475592, issued on Nov 30, 2022. The primary taxonomy on file is Clinical Laboratory Director (Non-physician) (247ZC0005X), and the practice location is in Glen Carbon, IL. The record was last updated on Nov 30, 2022.