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General NPI Number Information
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NPI Number | 1417904285
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Entity Type | Organization
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Legal Business Name | ALVERNO CLINICAL LABORATORIES, LLC
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Dates
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Enumeration Date | 05/27/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2434 INTERSTATE PLAZA DR
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City | HAMMOND
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State | IN
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Zip | 46324-3361
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Country | US
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Telephone | 219-989-3700
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Fax | 219-989-3900
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Provider Business Mailing Address
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Address Line | 2434 INTERSTATE PLAZA DR
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City | HAMMOND
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State | IN
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Zip | 46324-3361
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Country | US
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Telephone | 219-989-3700
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Fax | 219-989-3900
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Authorized Official
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Title or Position | PRESIDENT / CEO
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Name | CHERYL VANCE
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Credential |
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Telephone | 219-989-3714
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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