NPI Details
TIDE LABORATORIES, LLC is a clinical medical laboratory in Fort Payne, AL. The provider is (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. TIDE LABORATORIES, LLC NPI is 1306343231. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Tide Tox, Llc.
The provider's business location address is:
913 AIRPORT RD W STE B
FORT PAYNE, AL
ZIP 35968-315
Phone: (256) 845-1261
The provider's authorized official is Trevor Jordan Cleckler .
The authorized official title is Member and has the following contact phone number (256) 516-4153.
The CLIA number assigned to this NPI record is 01D2119386 - independent with a certificate type of Certificate of Accreditation.
The enumeration date for this NPI number is 4/8/2018 and was last updated on 4/8/2018.
Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 291U00000X | Clinical Medical Laboratory | | 01D2119386 | ALABAMA | Yes |
