TIDE LABORATORIES, LLC (NPI# 1306343231) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306343231 |
| Entity Type | Organization |
| Organization Name | TIDE LABORATORIES, LLC |
| Other Organization Name | TIDE TOX, LLC |
| Practice Address |
913 Airport Rd W Ste B Fort Payne AL 35968-3315 |
| Practice Telephone | 2568451261 |
| Mailing Telephone | 2568451261 |
| Enumeration Date | 2018-04-08 |
| Last Update Date | 2018-04-08 |
| Authorized Official Name | TREVOR JORDAN CLECKLER (MEMBER) |
| Authorized Official Telephone | 2565164153 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | 01D2119386 | AL | Laboratories |
| Other Name | Type Code |
|---|---|
| Tide Tox, LLC | Former Legal Business Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Alabama Business Registrations | Tide Laboratories, LLC | 3008 Forest Ave Nw, Fort Payne, AL 35968 |
| Street Address |
913 AIRPORT RD W STE B |
| City | FORT PAYNE |
| State | AL |
| Zip Code | 35968-3315 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417382623 | Lori Land Camp | Pharmacist | 101 Cracker Barrel Row, Ft Payne, AL 35968 | 2013-09-06 |
| 1841424959 | Ashley Renee Cole | Emergency Medicine | 590 Medical Center Dr, Fort Payne, AL 35968 | 2009-05-05 |
| 1871758938 | Michael Steven Digby | Dermatology | 1403 Old Water Works Rd Sw, Fort Payne, AL 35968 | 2008-07-28 |
| 1356516611 | Robyn Reesman, O.d.,inc. | Optometrist | 2001 Glenn Blvd. Sw, Fort Payne, AL 35968 | 2008-04-28 |
| 1124219902 | Rebecca Burns Ingram | Occupational Therapist | 2804 Greenhill Blvd Nw Ste 102, Fort Payne, AL 35968 | 2007-08-06 |
| 1467657957 | Palmer Orthopaedic & Sports Medicine, PC | Orthopaedic Surgery | 315 Medical Center Dr. Sw, Fort Payne, AL 35968 | 2007-06-15 |
| 1225171309 | Dekalb County Health Dept Offsite Epsdt | Public Health or Welfare | 2401 Calvin Dr, S.w., Ft. Payne, AL 35968 | 2007-02-15 |
| 1376612648 | American Hospice -- Fort Payne | Hospice Care, Community Based | 103 3rd Street North West, Suite 202, Fort Payne, AL 35968 | 2006-11-08 |
| 1316978588 | Bhc-palmer Orthopaedics and Sports Medicine | Specialist | 315 Medical Park, Fort Payne, AL 35968 | 2006-07-06 |
| 1487694782 | Fort Payne Hospital Corporation | Hospitalist | 200 Medical Center Dr., Fort Payne, AL 35968 | 2006-06-07 |
| Find all providers in zip 35968 | ||||
| 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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|---|---|---|---|---|
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| 1619574621 | Prestige Laboratory Services | Clinical Medical Laboratory | 857 Downtowner Blvd Ste H, Mobile, AL 36609-5420 | 2020-10-02 |
| 1740897123 | Labs Plus, LLC | Clinical Medical Laboratory | 2701 Mall Dr Ste 7204, Florence, AL 35630-7502 | 2020-09-29 |
| 1841800232 | Amh Staffing Agency | Clinical Medical Laboratory | 9925 County Road 63, Plantersville, AL 36758-2853 | 2020-07-31 |
| 1861012361 | Quest Diagnostics Clinical Laboratories Inc | Clinical Medical Laboratory | 129 Mitylene Park Lane, Montgomery, AL 36117-3758 | 2020-04-24 |
| 1407487465 | Golden Point Solutions LLC | Clinical Medical Laboratory | 411a Lorna Sq, Vestavia Hills, AL 35216-5418 | 2020-01-29 |
| 1386284156 | Magnolia Diagnostic Laboratories, LLC | Clinical Medical Laboratory | 2868 Acton Rd Ste 205, Vestavia, AL 35243-2502 | 2020-01-09 |
| 1780220863 | Sharon Masters | Clinical Medical Laboratory | 1930 Edwards Lake Rd Ste 138, Birmingham, AL 35235-3720 | 2019-11-23 |
| 1518518968 | Daniel Loper | Clinical Medical Laboratory | 3750 Moffett Rd, Mobile, AL 36618-1208 | 2019-09-26 |
| 1124676796 | Quest Diagnostics Clinical Laboratories Inc | Clinical Medical Laboratory | 1845 Cherry St Fl 2, Montgomery, AL 36107-2613 | 2019-08-27 |
| Find all providers with the same taxonomy | ||||
| City | FORT PAYNE |
| Zip Code | 35968 |
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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.