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Mr. William Richard Woodruff
Clinical Laboratory Director (Non-physician) in Lower Brule, South Dakota
NPI 1053514554

William Richard Woodruff is a Clinical Laboratory Director (Non-physician) based in Lower Brule, SD and is specialized in Clinical Laboratory Director, Non-physician. William Richard Woodruff practices in Lower Brule, SD. The NPI Number for William Richard Woodruff is 1053514554 and holds a License No. (South Dakota).

The current practice location address for William Richard Woodruff is 601 Gall Street, Lower Brule, SD and can be reached out via phone at 605-473-8246 and via fax at 605-473-0607.

Location: 601 Gall Street, Lower Brule, SD, 57548-0248
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1053514554
Provider Name
William Richard Woodruff
Credential
Provider Entity Type
Individual
Gender
Male
Address
601 Gall Street, Lower Brule, SD, 57548-0248
Phone Number
605-473-8246
Fax Number
605-473-0607
Provider Enumeration Date
06/11/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
601 Gall Street
City
Lower Brule
State
South Dakota
Zip
57548-0248
Phone Number
605-473-8246
Fax Number
605-473-0607
person
Provider Business Mailing Address Details
Address
601 Gall Street
City
Lower Brule
State
South Dakota
Zip
57548-0248
Phone Number
605-473-8246
Fax Number
605-473-0607
person
Provider's Taxonomy Details 1
Type
Technologists, Technicians & Other Technical Service Providers
Classification
Technician, Pathology
Speciality
Clinical Laboratory Director, Non-physician
Taxonomy
247ZC0005X
License No.
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Definition
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.
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