Trident Labs, Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

TRIDENT LABS, INC.

Practice address

242 Howard Ave
Holland, MI 49424-6518

Phone

(855) 875-2532

NPI assigned

Apr 22, 2015

Organization subpart

No

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

Authorized official

Name

Nicole Kelsey

Title

Billing Manager

Phone

(616) 510-8125

Specialties & licenses 1

Addresses

Other names 1

• Trident Labs, LLC Former legal business name

Locations

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

{
    "created_epoch": "1429660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1605657600000",
    "number": "1619364262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "242 HOWARD AVE",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494246518",
            "telephone_number": "855-875-2532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 HOWARD AVE",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494246518",
            "telephone_number": "855-875-2532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIDENT LABS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-22",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-17",
        "status": "A",
        "authorized_official_last_name": "KELSEY",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "616-510-8125"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Trident Labs, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Trident Labs, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Kristin Travers, LMSW
• Treehouse Therapies LLC
• Trent Morell, PLLC
• Christina Lynn Trethewey
• Emily Ann Trey, CCAR
• Lucas Triemstra, P.A.-C
• Enjolie-Rose Muller Trinh
• Trio Wellspace, LLC
• Haiden Trowbridge
• Tyler S Truskoski, PA-C

• Clinical Medical Laboratory in Holland, MI
• Providers in Holland, MI by specialty
• Clinical Medical Laboratory in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2020; 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.