Provider Demographics
NPI:1861763658
Name:ALVERNO LABORATORIES, LLC
Entity type:Organization
Organization Name:ALVERNO LABORATORIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO AND PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SAM
Authorized Official - Middle Name:
Authorized Official - Last Name:TERESE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-803-4776
Mailing Address - Street 1:2434 INTERSTATE PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:IN
Mailing Address - Zip Code:46324-2671
Mailing Address - Country:US
Mailing Address - Phone:219-989-3700
Mailing Address - Fax:219-989-3900
Practice Address - Street 1:2434 INTERSTATE PLAZA DR.
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:IN
Practice Address - Zip Code:46324-2671
Practice Address - Country:US
Practice Address - Phone:219-989-3700
Practice Address - Fax:219-989-3900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-25
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory