Provider Demographics
NPI:1265860597
Name:ON THE GO LABORATORY SERVICES LLC
Entity Type:Organization
Organization Name:ON THE GO LABORATORY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:MULLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-322-5610
Mailing Address - Street 1:9898 BISSONNET ST
Mailing Address - Street 2:SUITE 670
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-8270
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9898 BISSONNET ST
Practice Address - Street 2:SUITE 670
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-8270
Practice Address - Country:US
Practice Address - Phone:504-322-5610
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-23
Last Update Date:2013-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty