Organization
ENVISION HEALTH LAB, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VINCE OJEDA (CEO)
(618) 717-8270
Entity
Organization
Contact information
Practice address
1716 CORPORATE XING, O FALLON, IL 62269-3743
(618) 717-8270
(618) 726-2030
Mailing address
1716 CORPORATE XING, O FALLON, IL 62269-3743
(618) 717-8270
(618) 726-2030
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
036.100502
IL
Other
Enumeration date
07/05/2016
Last updated
07/15/2016
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