National Provider Identifier Database

TETON CARDIOVASCULAR AND PULMONARY LABLLC
Physiological Laboratory, (Independent Physiological Lab)

A laboratory that operates independently of a hospital and physician?s office to furnish physiological diagnostic services (e.g. EEG?s , EKG?s, scans, etc.). Facilities offering ONLY physiological services are not certified as independent laboratories. If an independent laboratory offers physiological services IN ADDITION to clinical laboratory services, they are surveyed only for compliance with the clinical laboratory regulations because there are no health and safety regulations for physiological services.


Contact Information

TETON CARDIOVASCULAR AND PULMONARY LAB,LLC
2001 S WOODRUFF AVE
SUITE 12 B
IDAHO FALLS, ID83404-6374
Phone: 800-341-1043
Fax: 208-528-7971
Website:
Specialty Taxonomy Code
* Physiological Laboratory, (Independent Physiological Lab) 293D00000X

* Indicates primary specialty

NPI Profile & details for TETON CARDIOVASCULAR AND PULMONARY LAB,LLC

NPI Number 1699784413
Legal business name
LBN
TETON CARDIOVASCULAR AND PULMONARY LAB,LLC
Authorized official BRADEN CAZARES - (CEO)
Entity Organization
Organization subpart No
Enumeration date 08/08/2006
Last updated 05/06/2025 - More than a year ago
Sole proprietor1 Not specified
Identifiers
  • ID Medicaid: 807391800
  • ID Other: 8M795 BLUE CROSS OF IDAHO
  • ID Other: 000010153937 BLUE SHIELD OF IDAHO

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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