CLINIC LABORATORY (NPI# 1336205913) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336205913 |
| Entity Type | Organization |
| Organization Name | CLINIC LABORATORY |
| Practice Address |
2601 W Main St Carbondale IL 62901-1031 |
| Practice Telephone | 6185495361 |
| Practice Fax Number | 6185495128 |
| Mailing Telephone | 6185495361 |
| Mailing Fax Number | 6185495128 |
| Enumeration Date | 2006-12-28 |
| Last Update Date | 2008-05-09 |
| Authorized Official Name | MR. ALLAN N. NORMAN (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 6184575200 |
| Is Organization Subpart | Y |
| Parent Organization Name | CARBONDALE CLINIC, S.C. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | Laboratories |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | RR MEDICARE | 690003493 | 01 |
| IL | GHP | 196086 | 01 |
| IL | HEALTHLINK | 461070 | 01 |
| IL | LEGACY | 148511 | 01 |
| IL | HAMP | 044649 | 01 |
| Street Address |
2601 W MAIN ST |
| City | CARBONDALE |
| State | IL |
| Zip Code | 62901-1031 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548261399 | Jeffrey M Lehman | Allergy & Immunology | 2601 W Main St, Carbondale, IL 62901-1031 | 2005-08-02 |
| 1043846421 | Lindsay B Casolari | Nurse Practitioner | 2601 W Main St, Carbondale, IL 62901-1031 | 2020-03-18 |
| 1194367318 | Jessica Oakley | Nurse Practitioner | 2601 W Main St, Carbondale, IL 62901-1031 | 2019-10-09 |
| 1609424399 | Alexis Korbar | Social Worker | 2601 W Main St, Carbondale, IL 62901-1031 | 2019-08-27 |
| 1184196883 | Leslie Ann Hickman | Nurse Practitioner | 2601 W Main St, Carbondale, IL 62901-1031 | 2018-12-19 |
| 1679041685 | Kirsten Anne Beyers | Social Worker | 2601 W Main St, Carbondale, IL 62901-1031 | 2018-11-07 |
| 1457834178 | Brittany Elizabeth Pierce | Nurse Practitioner | 2601 W Main St, Carbondale, IL 62901-1031 | 2018-09-09 |
| 1306322110 | Katharine Johnson | Social Worker | 2601 W Main St, Carbondale, IL 62901-1031 | 2018-07-15 |
| 1437699147 | Gina Gladson | Nurse Practitioner | 2601 W Main St, Carbondale, IL 62901-1031 | 2017-02-28 |
| 1902349863 | Sarah Elizabeth Ruth Shannon | Nurse Practitioner | 2601 W Main St, Carbondale, IL 62901 | 2016-11-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558961268 | Gerad Aaron Harsy | Pharmacist | Walmart Pharmcy, 1450 East Main St, Carbondale, IL 62901 | 2020-10-30 |
| 1437708674 | Board of Trustees of Southern Illinois University | Clinic/Center | 300 W Oak Street, Carbondale, IL 62901 | 2019-09-10 |
| 1306317383 | Rachael O Johnson | Nurse Practitioner | 404 S. Lewis Ln, Carbondale, IL 62901 | 2018-12-17 |
| 1740795194 | Megan Marie Zimmerman | Nurse Practitioner | 1100 W Diann Ln., Carbondale, IL 62901 | 2017-12-07 |
| 1295244242 | Amy Elizabeth Prudencio | Social Worker | 1301 E. Walnut Street, Carbondale, IL 62901 | 2017-09-21 |
| 1740708171 | Theresa Aleise Goodin | Speech-Language Pathologist | 1301 East Walnut Street, Carbondale, IL 62901 | 2017-09-06 |
| 1144762527 | Kathleen Chwalisz Rigney | Psychologist | 306 West Mill Street, Neurorestorative, Carbondale, IL 62901 | 2016-11-16 |
| 1285185173 | Shawnee Health Service and Development Corp | Social Worker | 404 S. Lewis Lane, Carbondale, IL 62901 | 2016-10-17 |
| 1437605094 | Arielle Greer | Nurse's Aide | 510 E. Russell St., A, Carbondale, IL 62901 | 2016-09-01 |
| 1518413863 | Complete Family Eyecare of Carbondale, PC | Optometrist | 1241 East Walnut Street, Carbondale, IL 62901 | 2016-08-28 |
| Find all providers in zip 62901 | ||||
| Taxonomy Code | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205323763 | Laboratory Corporation of America | Clinical Medical Laboratory | 400 S Lewis Ln, Carbondale, IL 62901 | 2018-04-19 |
| 1275020992 | Laboratory Corporation of America | Clinical Medical Laboratory | 101 S Wall St, Carbondale, IL 62901 | 2018-04-18 |
| 1811303977 | Lab One LLC | Clinical Medical Laboratory | 400 S Lewis Ln, Carbondale, IL 62901-3547 | 2014-07-09 |
| 1831454909 | Lab One Inc | Clinical Medical Laboratory | 305 W Jackson St Ste 200, Carbondale, IL 62901-1474 | 2012-07-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235745670 | Rivercross Diagnostics Inc. | Clinical Medical Laboratory | 910 Broadway St Ste Ab, Quincy, IL 62301-2729 | 2020-09-21 |
| 1952915506 | Vip Labs LLC. | Clinical Medical Laboratory | 2555 Lincoln Hwy Ste 104, Olympia Fields, IL 60461-1938 | 2020-09-01 |
| 1538770276 | Precision Phlebotomy Inc | Clinical Medical Laboratory | 9241 S Roberts Rd, Hickory Hills, IL 60457-3809 | 2020-08-15 |
| 1316558182 | Southwest Medical Solutions Inc | Clinical Medical Laboratory | 5533 W 109th St Ste 101, Oak Lawn, IL 60453-5058 | 2020-08-13 |
| 1083232946 | Sjs Medical Labs, LLC D/b/a Arcpoint Labs of Libertyville | Clinical Medical Laboratory | 1659 Northwind Blvd, Libertyville, IL 60048-9613 | 2020-07-08 |
| 1922625961 | Abil Corporation | Clinical Medical Laboratory | 1375 Remington Rd Ste A, Schaumburg, IL 60173-4844 | 2020-06-25 |
| 1588280622 | Radiance Biosciences and Consultancy, LLC | Clinical Medical Laboratory | 1260 Iroquois Ave Ste 302, Naperville, IL 60563-8549 | 2020-06-24 |
| 1417573916 | Global Medical Solutionz Equipment & Transportation Co. | Clinical Medical Laboratory | 1334 Central Park Dr Ste 3, O Fallon, IL 62269-1784 | 2020-06-19 |
| 1538781174 | Harmone Labs, LLC | Clinical Medical Laboratory | 1622 S Taylorville Rd, Decatur, IL 62521-3951 | 2020-05-16 |
| 1225659204 | Gist Entities, LLC | Clinical Medical Laboratory | 11006 W 179th St, Orland Park, IL 60467-9440 | 2020-05-01 |
| Find all providers with the same taxonomy | ||||
| City | CARBONDALE |
| Zip Code | 62901 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.