Organization
LIFESTREAM HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SARAH A MERRITT M.D. (OWNER)
(301) 860-0305
Entity
Organization
Contact information
Practice address
4000 MITCHELLVILLE RD, SUITE B322, BOWIE, MD 20716-3104
(301) 860-0305
(301) 860-0307
Mailing address
4000 MITCHELLVILLE RD, SUITE B322, BOWIE, MD 20716-3104
(301) 860-0305
(301) 860-0307
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
090266
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
525405100
—
MD
Enumeration date
01/09/2017
Last updated
06/04/2020
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