Organization
LIPID ANALYSIS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CYNTHIA DEITRICK MS (DIRECTOR)
(217) 535-3878
Entity
Organization
Contact information
Practice address
326 N 7TH ST, SPRINGFIELD, IL 62701-1014
(217) 535-3878
(217) 522-1206
Mailing address
326 N 7TH ST, SPRINGFIELD, IL 62701-1014
(217) 535-3878
(217) 522-1206
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8420838
BLUE CROSS BLUE SHIELD
IL
Enumeration date
08/23/2005
Last updated
08/22/2020
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