Organization
LIGHTHOUSE DIAGNOSTIC TESTING
Active
Organization
LIGHTHOUSE DIAGNOSTIC TESTING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NATE' RUSSELL (MANAGER)
(217) 720-7449
Entity
Organization
Contact information
Practice address
1760 WABASH AVE, SPRINGFIELD, IL 62791-0836
(217) 720-7449
Mailing address
1760 WABASH AVE, SPRINGFIELD, IL 62791-0836
(217) 720-7449
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
08/08/2026
Last updated
08/08/2026
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