Organization
LABORATORY SERVICES OF INDIANA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHERRI MOWERY MT(ASCP) (LABORATORY MANAGER)
(812) 477-3977
Entity
Organization
Contact information
Practice address
955 S HEBRON AVE, SUITE C, EVANSVILLE, IN 47714-4085
(812) 477-3977
(812) 477-4506
Mailing address
955 S HEBRON AVE, SUITE C, EVANSVILLE, IN 47714-4085
(812) 477-3977
(812) 477-4506
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000222914
ANTHEM BCBS
IN
Enumeration date
05/23/2006
Last updated
08/22/2020
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