Provider Demographics
NPI:1164275095
Name:MOBILE LAB SOLUTION, LLC
Entity Type:Organization
Organization Name:MOBILE LAB SOLUTION, LLC
Other - Org Name:MOBILE LAB SOLUTION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:APRIL
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-523-9242
Mailing Address - Street 1:1524 W 87TH ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60620-4819
Mailing Address - Country:US
Mailing Address - Phone:877-662-4522
Mailing Address - Fax:
Practice Address - Street 1:1524 W 87TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60620-4819
Practice Address - Country:US
Practice Address - Phone:877-662-4522
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-10
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Multi-Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center