Healthcare Provider Details

I. General information

NPI: 1962800375
Provider Name (Legal Business Name): URBAN TESTING LABS AND HEALTH CARE SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/17/2014
Last Update Date: 11/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1451 MULLANPHY ST
SAINT LOUIS MO
63106-3114
US

IV. Provider business mailing address

1451 MULLANPHY ST
SAINT LOUIS MO
63106-3114
US

V. Phone/Fax

Practice location:
  • Phone: 314-437-5876
  • Fax:
Mailing address:
  • Phone: 314-241-1539
  • Fax: 314-241-1567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number State

VIII. Authorized Official

Name: MARVIN STEELE
Title or Position: OWNER
Credential:
Phone: 314-241-1517