Midwest Innovation Laboratory Llc
Specialty details in registry · Saint Louis, MO
At a glance
11475 Olde Cabin Rd Ste 150, Saint Louis, MO 63141-7129
NPPES record updated Feb 7, 2022. Public records can lag behind changes at a practice.
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Insurance participation and appointment availability are not established by these public records.
Practice location
11475 Olde Cabin Rd Ste 150Saint Louis, MO 63141-7129
Professional details: NPI, taxonomy & registry record
Registry details
- Primary taxonomy
- Specialty details in registry
- Taxonomy code
- 291U00000X
- Enumeration date
- Jun 9, 2020
- Record updated
- Feb 7, 2022
More registry details
- Provider type
- Organization · Type 2
- Other reported name
- <UNAVAIL>
Reported taxonomies and licenses
Specialty details in registry
291U00000X · Primary
License numbers and credentials are reported to NPPES; HCPList does not independently verify them.
Practice location
11475 Olde Cabin Rd Ste 150Saint Louis, MO 63141-7129
- Phone
- (314) 408-3394
- Fax
- (314) 942-6800
Mailing address
1027 DUTCH MILL DRBALLWIN, MO 630113678
Information may be outdated or incomplete. Confirm details directly with the practice. HCPList is an independent directory and is not affiliated with CMS.
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