TELLICA IMAGING, LLC
NPI 1457055774
Clinic/Center - Radiology in Manchester, NH
NPI Status: Active since March 29, 2023
Contact Information
1100 BICENTENNIAL DR STE 3B
MANCHESTER, NH
ZIP 03104
Phone: (603) 292-3491
- Organization
- Clinic/Center
- Radiology
- CLIA Number: 30D2302879
- CLIA Cert. Type: Other - IMAGING CTR
- CLIA Exp. Date: 04-16-2026
About TELLICA IMAGING, LLC
This page provides the complete NPI Profile along with additional information for Tellica Imaging, Llc, a provider established in Manchester, New Hampshire operating as a Clinic/center, focusing in radiology . The healthcare provider is registered in the NPI registry with number 1457055774 assigned on March 2023. The practitioner's primary taxonomy code is 261QR0200X. The provider is registered as an organization and their NPI record was last updated one year ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Mark Vawdrey (Chief Financial Officer)
- NPI
- 1457055774
- Provider Name
- TELLICA IMAGING, LLC
- Entity Type
- Organization
- Location Address
- 1100 BICENTENNIAL DR STE 3B MANCHESTER, NH 03104
- Location Phone
- (603) 292-3491
- Mailing Address
- 36 S STATE ST STE 2200 SALT LAKE CITY, UT 84111
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 03-29-2023
- Last Update Date
- 08-27-2025
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Radiology
- Taxonomy Code
- 261QR0200X
- Type
- Ambulatory Health Care Facilities
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 2085R0202X | Allopathic & Osteopathic Physicians | Radiology |
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 30D2302879
- Facility Type
- Other - IMAGING CTR
- Certificate Effective Date
- April 17, 2024
- Certificate Expiration Date
- April 16, 2026
- Laboratory Director
- R DOUGLAS GREALLY
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Tellica Imaging, Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1457055774, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 56. The final step is to find the difference between that total and the next multiple of ten (60 - 56 = 4).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 56 is 60. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1457055774, enumerated as an "organization" on March 29, 2023.
The provider is located at 1100 BICENTENNIAL DR STE 3B MANCHESTER, NH 03104 and the phone number is (603) 292-3491.
Clinic/Center with taxonomy code 261QR0200X and a focus in Radiology.
