Adeona Clinical Laboratory LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

14D1051026 Issued in IL

Legal business name

ADEONA CLINICAL LABORATORY LLC

Practice address

391 Quadrangle Dr
Suite N9
Bolingbrook, IL 60440-3442

Phone

(630) 378-2100

Fax

(630) 378-2990

NPI assigned

May 13, 2006

Last updated

Dec 15, 2010By the provider in NPPES

Organization subpart

Yes

Parent organization

ADEONA PHARMACEUTICALS, INCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Narayan Torke

Title

Director

Phone

(630) 378-2100

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292371200000",
    "number": "1366493355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "391 QUADRANGLE DR",
            "address_2": "SUITE N9",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604403442",
            "telephone_number": "630-378-2100",
            "fax_number": "630-378-2990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "391 QUADRANGLE DR",
            "address_2": "SUITE N9",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604403442",
            "telephone_number": "630-378-2100",
            "fax_number": "630-378-2990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADEONA CLINICAL LABORATORY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADEONA PHARMACEUTICALS, INC",
        "enumeration_date": "2006-05-13",
        "last_updated": "2010-12-15",
        "status": "A",
        "authorized_official_last_name": "TORKE",
        "authorized_official_first_name": "NARAYAN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "630-378-2100",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "IL",
            "license": "14D1051026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Bolingbrook, IL
• Providers in Bolingbrook, IL by specialty
• Clinical Medical Laboratory in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.