Organization
BRIN DIAGNOSTICS INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAN HARSHBARGER (MANAGER)
(309) 635-9963
Entity
Organization
Contact information
Practice address
3216 W KENWOOD, WEST PEORIA, IL 61604
(309) 635-9963
Mailing address
3216 W KENWOOD, WEST PEORIA, IL 61604
(309) 635-9963
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
49D1100708
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
49D1100708
CLIA
IL
Enumeration date
02/07/2013
Last updated
02/07/2013
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