Organization
COMPREHENSIVE HEMOSTASIS AND THROMBOSIS INSTITUTE
Active
Organization
COMPREHENSIVE HEMOSTASIS AND THROMBOSIS INSTITUTE
Active
Other names
Comprehensive Hemostasis and Thrombosis Laboratory
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY L DAVIS (EXECUTIVE DIRECTOR)
(309) 688-1345
Entity
Organization
Contact information
Practice address
4727 N SHERIDAN RD, PEORIA, IL 61614-5925
(309) 688-1345
(309) 688-0917
Mailing address
4727 N SHERIDAN RD, PEORIA, IL 61614-5925
(309) 688-1345
(309) 688-0917
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
14D0982678 CLIA
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7230099
BCBS OF IL
IL
01
—
P00115815
RAILROAD MEDICARE
—
Enumeration date
09/23/2005
Last updated
08/08/2008
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up