Organization
SPRINGFIELD CLINIC LLP
Active
Parent organization
SPRINGFIELD CLINIC LLP
Other names
Springfield Clinic Decatur Lab
Organization subpart
Yes
Provider details
NPI number
Legal business name
SPRINGFIELD CLINIC LLP
Authorized official
MR. ALAN NERONE (SENIOR VICE PRESIDENT & CFO)
(217) 528-7541
Entity
Organization
Contact information
Practice address
250 W KENWOOD AVE, DECATUR, IL 62526-4371
(217) 428-3424
Mailing address
1025 S 6TH ST, SPRINGFIELD, IL 62703-2403
(217) 528-7541
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14D0706922
CLIA
—
Enumeration date
05/27/2008
Last updated
04/18/2018
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