Organization
SPRINGFIELD CLINIC RIVERTON LAB
Active
Parent organization
SPRINFIELD CLINIC LLP
Organization subpart
Yes
Provider details
NPI number
Legal business name
SPRINFIELD CLINIC LLP
Authorized official
MR. ALAN NERONE (SENIOR VICE PRESIDENT & CFO)
(217) 528-7541
Entity
Organization
Contact information
Practice address
1275 N 7TH ST, SUITE A, RIVERTON, IL 62561-9739
(217) 525-4150
Mailing address
1025 S 6TH ST, SPRINGFIELD, IL 62703-2403
(217) 528-7541
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14D2020046
CLIA
—
Enumeration date
11/04/2011
Last updated
07/24/2017
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