Adeona Clinical Laboratory LLC

Organization Active NPI Clinical Medical Laboratory · Bolingbrook, IL

NPI 1366493355 · NPPES record last updated Dec 15, 2010

Key facts

NPI
1366493355
Entity type
Organization (NPI type 2)
Primary specialty
Clinical Medical Laboratory 291U00000X
License
14D1051026 (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
Organization subpart
Yes
Parent organization (as reported)
ADEONA PHARMACEUTICALS, INC

Authorized official

Name
Dr. Narayan Torke
Title
Director
Phone
(630) 378-2100

National Provider Directory

Locations

391 Quadrangle Dr
Ste N9
Bolingbrook, IL 60440
Phone (630) 378-2100

391 Quadrangle Dr
Ste N8
Bolingbrook, IL 60440
Phone (630) 378-2100

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 14D1051026 IL Yes

Addresses

Primary practice location

391 Quadrangle Dr
Suite N9
Bolingbrook, IL 60440-3442

Mailing address

391 Quadrangle Dr
Suite N9
Bolingbrook, IL 60440-3442
Phone (630) 378-2100

Other identifiers

IdentifierTypeStateIssuer
001MedicaidIL

Other providers in Bolingbrook, IL

All providers in Bolingbrook, IL · Clinical Medical Laboratory in Illinois

Sources for this page

Verify at the official NPI Registry.