Lifespring Laboratories

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

21D2149021 Issued in MD

Legal business name

LIFESPRING LABORATORIES

Practice address

2200 Garrison Blvd Ste 3013
Baltimore, MD 21216

Phone

(678) 561-2140

NPI assigned

Jun 21, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Donald Wilson

Title

Owner

Phone

(678) 561-3037

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1529539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533168000000",
    "number": "1780178764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 HIGHWAY 85 N STE 310-406",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302147738",
            "telephone_number": "678-561-3037",
            "fax_number": "667-260-6180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 GARRISON BLVD STE 3013",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21216",
            "telephone_number": "678-561-2140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESPRING LABORATORIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-21",
        "last_updated": "2018-08-02",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "DONALD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-561-3037"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MD",
            "license": "21D2149021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lifebridge Suburban Physicians Group, LLC
• Lifeline Med Supplies LLC
• Lifeline Med Supplies LLC
• Lifeskills Group LLC
• Lifespring Health and Wellness LLC
• Lifespring LLC
• Lifestream Health Center
• Lifetime Assisted Living LLC
• Lifetime Dental Care of Maryland, Badger, P.C.
• Lifting Stigmas and Changing Lives

• Clinical Medical Laboratory in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Clinical Medical Laboratory in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.