OrganizationActive
Health Ventures of Southern Illinois Inc
NPI 1396725974 · Clinical Medical Laboratory · Glen Carbon, IL
Provider details
- NPI number
- 1396725974
- Entity type
- Organization
- Primary specialty
- Clinical Medical LaboratoryLaboratories
- Organization subpart
- No
- Authorized official
- Edward Hughes, Executive Director(618) 343-0639
Specialties & taxonomies
Laboratories
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
4804 S State Route 157
Ste 200
Glen Carbon, IL 62034-1904
Phone: (618) 288-7064
Fax: (618) 288-7027
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 790051
St Louis, MO 63179-0051
Other names (DBA / former)
- Doing business as
- Tri Lab LLC
Registry dates
- Enumerated
- 2006-01-19
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.