Elite Diagnostics Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

ELITE DIAGNOSTICS INC

Practice address

1853 Craig Rd
Saint Louis, MO 63146-4711

Phone

(314) 485-1327

Fax

(314) 485-1227

NPI assigned

Jun 29, 2018

Organization subpart

No

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

Authorized official

Name

Mr. Naveen Nallamothu

Title

Owner

Phone

(510) 896-0805

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1530230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701561600000",
    "number": "1861987083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1853 CRAIG RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631464711",
            "telephone_number": "314-485-1327",
            "fax_number": "314-485-1227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1853 CRAIG RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631464711",
            "telephone_number": "314-485-1327",
            "fax_number": "314-485-1227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE DIAGNOSTICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-29",
        "last_updated": "2023-12-03",
        "certification_date": "2023-12-03",
        "status": "A",
        "authorized_official_last_name": "NALLAMOTHU",
        "authorized_official_first_name": "NAVEEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "510-896-0805",
        "authorized_official_name_prefix": "Mr."
    },
    "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
• Providers in Saint Louis, MO by specialty
• Clinical Medical Laboratory in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2023; 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.