Crestiva Diagnostics LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

CRESTIVA DIAGNOSTICS LLC

Practice address

9615 Keilman St Unit 200
Saint John, IN 46373-9406

Phone

(682) 238-8525

NPI assigned

Oct 22, 2026

Last updated

Oct 22, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Raghuveera Reddy Chintalacheruvu

Title

Owner

Phone

(682) 238-8525

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1792627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1792627200000",
    "number": "1114824190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9615 KEILMAN ST UNIT 200",
            "city": "SAINT JOHN",
            "state": "IN",
            "postal_code": "463739406",
            "telephone_number": "682-238-8525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9615 KEILMAN ST UNIT 200",
            "city": "SAINT JOHN",
            "state": "IN",
            "postal_code": "463739406",
            "telephone_number": "682-238-8525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESTIVA DIAGNOSTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-10-22",
        "last_updated": "2026-10-22",
        "certification_date": "2026-10-22",
        "status": "A",
        "authorized_official_last_name": "CHINTALACHERUVU",
        "authorized_official_first_name": "RAGHUVEERA REDDY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "682-238-8525"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Saint John, IN
• Providers in Saint John, IN by specialty
• Clinical Medical Laboratory in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.