MEDICARE: MALEMILE BLOOD MOBILE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1497602858
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MALEMILE BLOOD MOBILE LLC

Provider Business Mailing Address
First Line	:	5650 ARGONNE ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80249-8824
Country	:	US
Telephone Number	:	720-572-0736
Fax Number	:

Provider Business Practice Location Address
First Line	:	5650 ARGONNE ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80249-8824
Country	:	US
Telephone Number	:	720-572-0736
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CLAUDIA MALENA FARINAS COSTA
Credential	:	PHLEBOTOMIST
Telephone Number	:	720-572-0736

Provider Enumeration Date	:	03/14/2026
Last Update Date	:	03/18/2026

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