Organization
LIFEBLOOM LABS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TONEKA WATSON (OWNER)
(704) 665-8319
Entity
Organization
Contact information
Practice address
710 N BROAD ST STE 13, MOORESVILLE, NC 28115-9585
(704) 665-8319
Mailing address
PO BOX 3622, LUMBERTON, NC 28359-3622
(704) 665-8319
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
10/17/2023
Last updated
10/17/2023
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