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MY BLOOMING HEALTH MOBILE LLC NPI 1205272788


NPI Information

NPI: 1205272788
Provider Name: MY BLOOMING HEALTH MOBILE, LLC
Classification: Clinical Medical Laboratory - 291U00000X
Entity Type: Organization

CLIA Number: 26D2062572

Address:
2040 WOODSON RD # 204A
SAINT LOUIS, MO
ZIP 63114
Phone: (314) 942-3273
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MY BLOOMING HEALTH MOBILE, LLC is a clinical medical laboratory in Saint Louis, MO. The provider is (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. MY BLOOMING HEALTH MOBILE, LLC NPI is 1205272788. The provider is registered as an organization entity type.

The provider's business location address is:

2040 WOODSON RD # 204A
SAINT LOUIS, MO
ZIP 63114-697
Phone: (314) 942-3273
Fax: (314) 584-2205

The provider's authorized official is Danita Smith .
The authorized official title is Director and has the following contact phone number (314) 942-3272.

The CLIA number assigned to this NPI record is 26D2062572 - mobile lab with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/10/2013 and was last updated on 11/9/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QM2500XClinic/CenterMedical Specialty1309649MISSOURINo
2291U00000XClinical Medical LaboratoryYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11080096MEDICAIDMISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.