NPIMap

Organization Active NPI

Thyroid Specialty Laboratory Inc

  • Clinical Medical Laboratory
  • Fenton, MO
National Provider Identifier
1396175196
Registry record updated Sep 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
THYROID SPECIALTY LABORATORY INC
Doing business as
TEN Healthcare, LLC
Practice address
1636 Headland Dr
Fenton, MO 63026-2837
Phone
(314) 200-3040
Fax
(314) 200-3042
NPI assigned
Nov 15, 2013
Organization subpart
Yes
Parent organization
THYROID SPECIALTY LABORATORY, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 23, 2021

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

Authorized official

Name
Marcia Eckrich
Title
Director of Compliance & Credential
Phone
(314) 200-3040

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

1636 Headland Dr
Fenton, MO 63026-2837

Mailing address

1636 Headland Dr
Fenton, MO 63026-2837
Phone (314) 200-2040

Other identifiers 2

IdentifierTypeStateIssuer
26D0953866OtherCLIA
703274407MedicaidMO

Other names 1

  • TEN Healthcare, LLC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Thyroid Specialty Lab Inc3 organizations share this tax ID, including this one
Part of
Thyroid Specialty Lab Inc

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1384473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632355200000",
    "number": "1396175196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1636 HEADLAND DR",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630262837",
            "telephone_number": "314-200-2040",
            "fax_number": "314-200-3042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1636 HEADLAND DR",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630262837",
            "telephone_number": "314-200-3040",
            "fax_number": "314-200-3042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THYROID SPECIALTY LABORATORY INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THYROID SPECIALTY LABORATORY, INC.",
        "enumeration_date": "2013-11-15",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-23",
        "status": "A",
        "authorized_official_last_name": "ECKRICH",
        "authorized_official_first_name": "MARCIA",
        "authorized_official_title_or_position": "DIRECTOR OF COMPLIANCE & CREDENTIAL",
        "authorized_official_telephone_number": "314-200-3040"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "26D0953866",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "703274407",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TEN Healthcare, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fenton, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2021; 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.