Organization
MY BLOOMING HEALTH LAB, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DANITA L SMITH RN (OWNER)
(314) 942-3272
Entity
Organization
Contact information
Practice address
2040 WOODSON RD STE 204A, SAINT LOUIS, MO 63114-5697
(314) 942-3273
(314) 584-2205
Mailing address
2040 WOODSON RD STE 204A, SAINT LOUIS, MO 63114-5697
(314) 942-3273
(314) 584-2205
Taxonomy
Speciality
Code
Description
License number
State
247ZC0005X
Clinical Laboratory Director (Non-physician)
Primary
—
—
Other
Enumeration date
02/21/2022
Last updated
02/24/2022
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