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Organization
ESSENTIAL LAB LLC
Active
Organization
ESSENTIAL LAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHARDENEY TAJON MANERS (CO-CEO)
(314) 374-3438
Entity
Organization
Contact information
Practice address
3315 LANSING DR, SAINT ANN, MO 63074-3428
(314) 514-5166
(314) 932-0933
Mailing address
3315 LANSING DR, SAINT ANN, MO 63074-3428
(314) 514-5166
(314) 932-0933
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
251F00000X
Home Infusion Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
01/04/2022
Last updated
01/04/2022
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