Provider Demographics
NPI:1811702400
Name:INNOVEX DIAGNOSTIC SOLUTIONS LLC
Entity type:Organization
Organization Name:INNOVEX DIAGNOSTIC SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:A
Authorized Official - Last Name:CLOWERS
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:334-223-4435
Mailing Address - Street 1:2036 CHEROKEE RD
Mailing Address - Street 2:
Mailing Address - City:ALEXANDER CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35010-3439
Mailing Address - Country:US
Mailing Address - Phone:334-223-4435
Mailing Address - Fax:
Practice Address - Street 1:1 CHASE CORPORATE DR STE 400
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-7001
Practice Address - Country:US
Practice Address - Phone:334-223-4435
Practice Address - Fax:800-863-8054
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-11
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory