Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Green Lake Medical Clinic

Organization Clinical Medical Laboratory · NPI 1316087885

Green Lake Medical Clinic is a Clinical Medical Laboratory in Green Lake, Wisconsin. Licensed in Wisconsin. Registered with an NPI since 2007.

Licensed in
WI
In the registry since
2007
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Practice location Address checks out

N6205 Busse Dr
Green Lake, WI 54941-0429
Phone: (920) 294-3444
Fax: (920) 294-6660
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Medical Laboratory (primary) Taxonomy 291U00000X · Licence 17659 (WI)

Record details

NPI number1316087885
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Thomas Willett — President · (920) 294-3444
NPI enumeratedFebruary 7, 2007
Last updated in NPPESAugust 22, 2020
Mailing addressPo Box 429, N6205 Busse Drive, Green Lake, WI 54941-0429