Provider Demographics
NPI:1326803206
Name:LABPORT MOBILE INC
Entity Type:Organization
Organization Name:LABPORT MOBILE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SHANICHRA
Authorized Official - Middle Name:
Authorized Official - Last Name:RADCLIFFE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-735-9364
Mailing Address - Street 1:1900 S KANNER HWY APT 9-106
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-7216
Mailing Address - Country:US
Mailing Address - Phone:708-735-9364
Mailing Address - Fax:
Practice Address - Street 1:1900 S KANNER HWY APT 9-106
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-7216
Practice Address - Country:US
Practice Address - Phone:708-735-9364
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-19
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty