LIFEBLOOM LABS LLC
NPI 1275315004
Clinical Medical Laboratory in Mooresville, NC

Active since October 17, 2023
710 N BROAD ST STE 13, MOORESVILLE, NC 28115(704) 665-8319 Get Directions Write a Review

NPPES record last updated: October 17, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Lifebloom Labs Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LIFEBLOOM LABS LLC (NPI 1275315004) is a healthcare organization registered as a clinical medical laboratory in Mooresville, North Carolina and active in the NPI registry since October 2023. The organization lists Toneka Watson, Owner, as its authorized official.

NPPES Registry Identity

NPI1275315004
Entity TypeOrganization
Primary Taxonomy291U00000X
Legal Business NameLIFEBLOOM LABS LLC
Location Address710 N BROAD ST STE 13Mooresville, NC 28115-9585
Mailing AddressPo Box 3622Lumberton, NC 28359-3622 · (704) 665-8319
Organization SubpartNo
Authorized OfficialToneka WatsonOwner · (704) 665-8319
Enumeration DateOctober 17, 2023
NPPES CertifiedOctober 17, 2023
NPI 1275315004 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinical Medical LaboratoryLaboratories
Taxonomy Code291U00000X
Definition

(1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology.

710 N BROAD ST STE 13, Mooresville, NC 28115

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 34D2292547

Life Bloom Lab LLC · Mooresville, NC
Expired · Oct 25, 2025
CLIA Number34D2292547
Laboratory TypeDiagnostics Lab
Certificate Effective DateOctober 26, 2023
Certificate Expiration DateOctober 25, 2025
Laboratory DirectorToneka Watson
Laboratory Phone(704) 665-8319
Laboratory LocationLife Bloom Lab LLC710 N Broad St Unit 13, Mooresville, NC 28115
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1275315004, enumerated as an "organization" on October 17, 2023.

The provider is located at 710 N BROAD ST STE 13 MOORESVILLE, NC 28115 and the phone number is (704) 665-8319.

Clinical Medical Laboratory with taxonomy code 291U00000X.