ST LUKES CENTER FOR DIAGNOSTIC IMAGING LLC - NPI 1932145828

Q: What is St Lukes Center For Diagnostic Imaging LLC's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

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About St Lukes Center For Diagnostic Imaging Llc NPPES

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

ST LUKES CENTER FOR DIAGNOSTIC IMAGING LLC (NPI 1932145828) is a healthcare organization registered as a diagnostic radiology in Ofallon, Missouri and active in the NPI registry since June 2006. The organization lists Donald D Jacobsen, Officer On The Board Secretary, as its authorized official.

NPPES Registry Identity

NPI1932145828

Entity TypeOrganization

Primary Taxonomy2085R0202X

Legal Business NameST LUKES CENTER FOR DIAGNOSTIC IMAGING LLC

Location Address5551 WINGHAVEN BOULEVARD, SUITE 60Ofallon, MO 63368-3618

Mailing AddressPo Box 790120St Louis, MO 63179-0120 · (952) 542-8553 · Fax (952) 513-6880

Phone(636) 625-4434

Fax(636) 625-4432

Organization SubpartNo

Authorized OfficialDonald D JacobsenOfficer On The Board Secretary · (952) 543-6500

Enumeration DateJune 21, 2006

Last NPPES UpdateJuly 21, 2008

✔ NPI 1932145828 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians

Taxonomy Code2085R0202X

Definition

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

5551 WINGHAVEN BOULEVARD, Ofallon, MO 63368

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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 26D1079002

St Luke's Rayus Radiology Winghaven · O Fallon, MO

Expired · Jan 22, 2026

CLIA Number26D1079002

Laboratory TypeDiagnostic Imaging Center

Certificate Effective DateJanuary 23, 2024

Certificate Expiration DateJanuary 22, 2026

Laboratory DirectorJennifer L. Demertzis

Laboratory Phone(636) 625-4434

Laboratory LocationSt Luke's Rayus Radiology Winghaven5551 Winghaven Blvd, Ste 60, O Fallon, MO 63368

CLIA data matches this NPI record on: Phone

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 St Lukes Center For Diagnostic Imaging LLC's NPI number?

The NPI number for St Lukes Center For Diagnostic Imaging LLC is 1932145828. It was assigned to this organization in the NPPES registry on June 21, 2006.

Where is St Lukes Center For Diagnostic Imaging LLC located?

St Lukes Center For Diagnostic Imaging LLC is located at 5551 Winghaven Boulevard Suite 60, Ofallon, MO 63368. The listed phone number is (636) 625-4434.

What is St Lukes Center For Diagnostic Imaging LLC's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

When was this NPI record last updated?

The NPPES record for St Lukes Center For Diagnostic Imaging LLC was last updated on July 21, 2008. NPI Profile syncs with the weekly NPPES data releases published by CMS.