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LACLEDE GROVES
NPI 1457924755
Licensed Practical Nurse in Saint Louis, MO

Active since July 23, 2021CLIA 26D2072865 · Waiver
727 S LACLEDE STATION RD, SAINT LOUIS, MO 63119(314) 446-2462(314) 446-2397 Get Directions Write a Review

NPPES record last updated: July 23, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Laclede Groves NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LACLEDE GROVES (NPI 1457924755) is a healthcare organization registered as a licensed practical nurse in Saint Louis, Missouri and active in the NPI registry since July 2021. The organization holds a CLIA Waiver certificate valid through May 1, 2028 and lists Otha Thomas, Director Of Health Services, as its authorized official.

NPPES Registry Identity

NPI1457924755
Entity TypeOrganization
Primary Taxonomy164W00000X
Legal Business NameLACLEDE GROVES
Location Address727 S LACLEDE STATION RDSaint Louis, MO 63119-4911
Mailing Address727 S Laclede Station RdSaint Louis, MO 63119-4911 · (314) 446-2462 · Fax (314) 446-2397
Phone(314) 446-2462
Fax(314) 446-2397
Organization SubpartNo
Authorized OfficialOtha ThomasDirector Of Health Services · (314) 446-2462
Enumeration DateJuly 23, 2021
NPPES CertifiedJuly 23, 2021
✔ NPI 1457924755 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLicensed Practical NurseNursing Service Providers
Taxonomy Code164W00000X
Definition
A licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.
727 S LACLEDE STATION RD, Saint Louis, MO 63119
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 26D2072865

Laclede Groves · Saint Louis, MO
Active · expires May 1, 2028
CLIA Number26D2072865
Laboratory TypeCommunity Clinic
Certificate Effective DateMay 2, 2026
Certificate Expiration DateMay 1, 2028
Laboratory DirectorValeria Cooper
Laboratory Phone(314) 968-5570
Laboratory LocationLaclede Groves723 South Laclede Station Road, Saint Louis, MO 63119
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Laclede Groves's NPI number?

The NPI number for Laclede Groves is 1457924755. It was assigned to this organization in the NPPES registry on July 23, 2021.

Where is Laclede Groves located?

Laclede Groves is located at 727 S Laclede Station Rd, Saint Louis, MO 63119. The listed phone number is (314) 446-2462.

What is Laclede Groves's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

Does Laclede Groves hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 26D2072865) is associated with this NPI, valid through May 1, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Laclede Groves was last updated on July 23, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.