Elite Diagnostic Services LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

ELITE DIAGNOSTIC SERVICES LLC

Practice address

1105 Olive St
Saint Louis, MO 63101-1908

Phone

(314) 347-6007

Fax

(314) 347-6007

NPI assigned

Aug 19, 2026

Organization subpart

No

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

Authorized official

Name

Keturah Wilson

Title

Member

Phone

(314) 347-6007

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1787097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1787097600000",
    "number": "1518872845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 OLIVE ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631011908",
            "telephone_number": "314-347-6007",
            "fax_number": "314-347-6007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 OLIVE ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631011908",
            "telephone_number": "314-347-6007",
            "fax_number": "314-347-6007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE DIAGNOSTIC SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-08-19",
        "last_updated": "2026-08-19",
        "certification_date": "2026-08-19",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "KETURAH",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "314-347-6007"
    },
    "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 Louis, MO
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• Clinical Medical Laboratory in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 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.