Organization
VA MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VAN R HENDRICKSON MT(ASCP) (LABORATORY MANAGER)
(618) 993-4113
Entity
Organization
Contact information
Practice address
2401 W MAIN ST, MARION, IL 62959-1188
(618) 993-4113
(618) 998-5665
Mailing address
2401 W MAIN ST, MARION, IL 62959-1188
(618) 993-4113
(618) 998-5665
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
IL
Other
Enumeration date
03/28/2008
Last updated
03/28/2008
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