SPECIALTY LABS PLLC (NPI# 1114227246) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114227246 |
| Entity Type | Organization |
| Organization Name | SPECIALTY LABS PLLC |
| Practice Address |
951 E Plaza Dr Suite 170 Eagle ID 83616 |
| Practice Telephone | 2089393505 |
| Practice Fax Number | 9399393507 |
| Mailing Telephone | 2089393505 |
| Mailing Fax Number | 9399393507 |
| Enumeration Date | 2010-10-22 |
| Last Update Date | 2010-10-22 |
| Authorized Official Name | DR. TAMARA SIMON (OWNER/LAB DIRECTOR) |
| Authorized Official Telephone | 2089393505 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | ID | Laboratories |
| Street Address |
951 E PLAZA DR SUITE 170 |
| City | EAGLE |
| State | ID |
| Zip Code | 83616 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386643146 | Cynthia Ray Culp | Nurse Practitioner | 951 E Plaza Dr, Suite Number 110, Eagle, ID 83616-6566 | 2005-07-14 |
| 1356985816 | Synergy Health and Wellness | Chiropractor | 951 E Plaza Dr, Eagle, ID 83616-6566 | 2019-10-29 |
| 1528427796 | Danielle Sutton | Nurse Practitioner | 951 E Plaza Dr, #170, Eagle, ID 83616-6566 | 2016-02-16 |
| 1912270661 | Metabolic Health and Longevity Center | Clinic/Center | 951 E Plaza Dr, Suite 150, Eagle, ID 83616-6566 | 2012-02-10 |
| 1407129125 | Renu Medispa | Clinic/Center | 951 E Plaza Dr, Suite 150, Eagle, ID 83616-6566 | 2012-02-10 |
| 1144469735 | Claudia Parcells | Nurse Practitioner | 951 E Plaza Dr, Suite 170, Eagle, ID 83616-6566 | 2009-02-05 |
| 1104983881 | Rocky Mountain Health and Wellness LLC | Nurse Practitioner | 951 E Plaza Dr, Ste 110, Eagle, ID 83616-6566 | 2007-01-02 |
| 1891730917 | Tamara Marie Simon | Obstetrics & Gynecology | 951 E Plaza Dr, Suite 170, Eagle, ID 83616-6566 | 2006-06-20 |
| 1649237140 | Karen Angela Howell | Physical Therapist | 951 E Plaza Dr, Eagle, ID 83616-6566 | 2006-04-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730714049 | Care Medical Housecalls PC | Nurse Practitioner | 2040 E Holgate Ct, Eagle, ID 83616 | 2020-03-06 |
| 1629613823 | Counseling Solutions Center LLC | Marriage & Family Therapist | 2618 East Snocreek, Eagle, ID 83616 | 2019-11-12 |
| 1245726918 | Tracy Lyn Hagadorn | Midwife | 182 State Street, Eagle, ID 83616 | 2018-07-06 |
| 1861922627 | Nicholas A. Stelzner | Counselor | 2419 W. State St. Suite 8, Boise, ID 83616 | 2017-06-14 |
| 1184080210 | Gabriel Guerrero | Dermatology | 323 E Riverside Dr Ste 234, Eagle, ID 83616 | 2016-01-05 |
| 1376940668 | Cecilia Jo Hickam | Dental Hygienist | 1121 E. State Street, Suite - 102-d, Eagle, ID 83616 | 2014-12-02 |
| 1871912634 | Christine E Birch | Psychiatry & Neurology | 1032 S Bridgeway Pl Ste 110, Eagle, ID 83616 | 2014-04-09 |
| 1043552524 | Tori Croshaw | Social Worker | 372 S Eagle Rd Ste 190, Eagle, ID 83616 | 2013-03-21 |
| 1053650010 | Kellie Ann Northam | Nurse Practitioner | 192 West State Street, Eagle, ID 83616 | 2013-02-11 |
| 1437494457 | Mary Beth Roehling | Nurse Practitioner | 2040 E Hologate Ct, Eagle, ID 83616 | 2012-12-03 |
| Find all providers in zip 83616 | ||||
| Taxonomy Code | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
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| 1457984981 | Mini-cassia Misdemeanor | Clinical Medical Laboratory | 1359 Hansen Ave, Burley, ID 83318-1821 | 2020-02-12 |
| 1831743228 | Quest Diagnostics Clinical Laboratories Inc | Clinical Medical Laboratory | 215 E Hawaii Ave Ste B-100, Nampa, ID 83686-6011 | 2019-07-24 |
| 1801390521 | Local Lab LLC | Clinical Medical Laboratory | 8382 N Wayne Dr Ste 201, Hayden, ID 83835-6028 | 2018-03-19 |
| 1326553421 | The Local Lab, LLC | Clinical Medical Laboratory | 8382 N Wayne Dr Ste 103, Hayden, ID 83835-6028 | 2017-12-11 |
| 1457722092 | Bear Tooth Laboratory, LLC | Clinical Medical Laboratory | 1125 E Pine Ave, Ste B, Meridian, ID 83642-5955 | 2015-10-08 |
| 1730550377 | Landbank Laboratories, LLC | Clinical Medical Laboratory | 1020 Land Bank St, Suite B, Idaho Falls, ID 83402-1809 | 2015-10-08 |
| 1629486311 | Julia Anne Sanford Biggerstaff | Clinical Medical Laboratory | 4355 W Emerald St, Suite 140, Boise, ID 83706-2050 | 2014-07-26 |
| 1194150003 | Absolute Drug Testing, LLC | Clinical Medical Laboratory | 5433 N Government Way, Suite B, Coeur D Alene, ID 83815-9259 | 2013-09-10 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.