NPIMap

Organization Active NPI

Washington University

Doing business as Clinical Cytogenetics Laboratory

  • Clinical Medical Laboratory
  • Saint Louis, MO
National Provider Identifier
1043414113
Registry record updated Apr 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
WASHINGTON UNIVERSITY
Doing business as
Clinical Cytogenetics Laboratory
Practice address
4320 Forest Park Ave
Suite 209
Saint Louis, MO 63108-2821
Phone
(314) 362-5641
NPI assigned
Jun 13, 2007
Last updated
Apr 25, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Cathy Eghigian
Title
Senior Director Managed Care
Phone
(314) 273-0770

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

4320 Forest Park Ave
Suite 209
Saint Louis, MO 63108-2821

Mailing address

PO Box 7412011
Chicago, IL 60674-2011
Phone (314) 362-5641

Other identifiers 1

IdentifierTypeStateIssuer
705187201MedicaidMO

Other names 2

  • Clinical Cytogenetics Laboratory Doing business as
  • Washington University Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070907000440 MO Part B Supplier - Independent Clinical Laboratory 9830008770 3 other NPIs on this enrollment
Practice locations: Saint Louis, MO

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Robert J Raish MD81 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 16

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 16

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745539200000",
    "number": "1043414113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412011",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742011",
            "telephone_number": "314-362-5641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 FOREST PARK AVE",
            "address_2": "SUITE 209",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631082821",
            "telephone_number": "314-362-5641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASHINGTON UNIVERSITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-13",
        "last_updated": "2025-04-25",
        "certification_date": "2025-04-25",
        "status": "A",
        "authorized_official_last_name": "EGHIGIAN",
        "authorized_official_first_name": "CATHY",
        "authorized_official_title_or_position": "SENIOR DIRECTOR MANAGED CARE",
        "authorized_official_telephone_number": "314-273-0770"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "705187201",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clinical Cytogenetics Laboratory",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Washington University",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.