Organization
SPRINGFIELD CLINIC LLP
Active
Parent organization
SPRINGFIELD CLINIC LLP
Other names
Springfield Clinic Carpenter Lab
Organization subpart
Yes
Provider details
NPI number
Legal business name
SPRINGFIELD CLINIC LLP
Authorized official
JAMES ALAN NERONE (SENIOR VP & CFO)
(217) 528-7541
Entity
Organization
Contact information
Practice address
350 W CARPENTER ST, SPRINGFIELD, IL 62702-4902
(217) 528-7541
Mailing address
PO BOX 19248, SPRINGFIELD, IL 62794-9248
(217) 528-7541
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14D0891040
CLIA
—
Enumeration date
04/26/2018
Last updated
04/26/2018
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