Healthcare Provider Details

I. General information

NPI: 1356009492
Provider Name (Legal Business Name): RCM MOBILE LABORATORIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/06/2021
Last Update Date: 12/06/2021
Certification Date: 12/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5419 LILIAN AVE
SAINT LOUIS MO
63120-2322
US

IV. Provider business mailing address

5419 LILIAN AVE
SAINT LOUIS MO
63120-2322
US

V. Phone/Fax

Practice location:
  • Phone: 314-728-2800
  • Fax:
Mailing address:
  • Phone: 314-728-2800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code246QH0000X
TaxonomyHematology Specialist/Technologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code246QL0900X
TaxonomyLaboratory Management Specialist/Technologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 7
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name: MS. RECITA CARNELLA MITCHELL
Title or Position: INSTRUCTOR
Credential: PHLEBOTOMY
Phone: 314-728-2800