Healthcare Provider Details

I. General information

NPI: 1376297838
Provider Name (Legal Business Name): 1ST RATE COVID-19 SCREENING AND TOXICOLOGY SCREENING COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/03/2022
Last Update Date: 02/03/2022
Certification Date: 02/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8916 SCOTTDALE AVE
SAINT LOUIS MO
63136-1567
US

IV. Provider business mailing address

8916 SCOTTDALE AVE
SAINT LOUIS MO
63136-1567
US

V. Phone/Fax

Practice location:
  • Phone: 314-498-9777
  • Fax:
Mailing address:
  • Phone: 314-498-9777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: KATINA GRICE-THOMAS
Title or Position: OWNER
Credential:
Phone: 314-498-9777