DYNAMIC DNA LABORATORIES, LLC (NPI# 1659738631) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659738631 |
| Entity Type | Organization |
| Organization Name | DYNAMIC DNA LABORATORIES, LLC |
| Practice Address |
2144 E Republic Rd Suite B204 Springfield MO 65804-4623 |
| Practice Telephone | 4173191047 |
| Mailing Telephone | 4173191047 |
| Enumeration Date | 2016-01-21 |
| Last Update Date | 2016-01-21 |
| Authorized Official Name | MR. AUSTIN DAVID LEE O'REILLY (OWNER, GENERAL SUPERVISOR) |
| Authorized Official Telephone | 4178616723 |
| Authorized Official Credential | M.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | LC001418393 | MO | Laboratories |
| Street Address |
2144 E REPUBLIC RD SUITE B204 |
| City | SPRINGFIELD |
| State | MO |
| Zip Code | 65804-4623 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861001224 | Loehr Medical Group LLC | Counselor | 2144 E Republic Rd, Suite A-104, Springfield, MO 65804 | 2020-07-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790393049 | Kathy Forson | Nurse Practitioner | 1235 E. Cherokee St., Springfield, MO 65804 | 2020-07-22 |
| 1306498779 | Anne B Summers, LLC | Social Worker | 1310 E. Kingsley St., Ste C, Springfield, MO 65804 | 2019-07-15 |
| 1790241800 | Margaret Mary Hart | Social Worker | 1845 S Rogers Ave, Springfield, MO 65804 | 2019-02-13 |
| 1598254666 | Casey Carr | Optometrist | 1229 E Seminole St Ste 110, Springfield, MO 65804 | 2018-05-04 |
| 1124520697 | Shelby D White | Behavioral Analyst | 1300 E. Bradford Parkway, Springfield, MO 65804 | 2018-03-01 |
| 1316448343 | Karl Lynham | Massage Therapist | 1200 E Woodhurst Dr R300, Springfield, MO 65804 | 2018-02-25 |
| 1699273763 | Leah Wilson | Counselor | 1322 E Woodgate, Springfield, MO 65804 | 2018-01-24 |
| 1295242626 | Matthew Crisp | Physical Therapist | 3252 E Independence St, Springfield, MO 65804 | 2018-01-08 |
| 1518491042 | Crystal Spangler | Dietitian, Registered | 1965 S Fremont Ave Ste 220, Springfield, MO 65804 | 2017-04-11 |
| 1588012033 | Jeffrey Williams | Pharmacist | 1235 E. Cherokee, Springfield, MO 65804 | 2016-05-25 |
| Find all providers in zip 65804 | ||||
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104474360 | Mmi Laboratory Services, LLC | Clinical Medical Laboratory | 1927 S National Ave Ste A, Springfield, MO 65804-2279 | 2019-08-30 |
| 1235613712 | Identi-check, Inc | Clinical Medical Laboratory | 3 N Old State Capitol Plz, Springfield, IL 62701-1313 | 2018-09-20 |
| 1790170447 | Labworks LLC | Clinical Medical Laboratory | 6412 Brandon Ave Ste 342, Springfield, VA 22150-2513 | 2015-03-31 |
| 1235413428 | Labone LLC | Clinical Medical Laboratory | 1242 E Independence St Ste 200, Springfield, MO 65804-4284 | 2011-10-06 |
| 1689966038 | Springfield Clinic Soga Lab | Clinical Medical Laboratory | 900 N 1st St Fl 1, Springfield, IL 62702-3749 | 2011-05-04 |
| 1891023164 | Illinois Department of Public Health | Clinical Medical Laboratory | 525 West Jefferson, 1st Floor, Springfield, IL 62761 | 2009-11-25 |
| 1124286976 | Springfield Clinic Hematology Oncology Lab | Clinical Medical Laboratory | 900 N 1st St Fl 4, Springfield, IL 62702-3749 | 2008-05-29 |
| 1992925580 | Illinois Department of Public Health | Clinical Medical Laboratory | 825 N Rutledge St, Springfield, IL 62702-4910 | 2007-04-26 |
| 1205975174 | Tri-lakes Pathology Services,l.l.c. | Clinical Medical Laboratory | 1000 E Primrose St Ste 300, Springfield, MO 65807-5178 | 2007-02-06 |
| 1497820435 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc | Clinical Medical Laboratory | 6501 Loisdale Road, Springfield, VA 22150-1845 | 2006-11-22 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 65804 |
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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.