Provider Demographics
NPI:1497417877
Name:QUALITY MOBILE LAB
Entity Type:Organization
Organization Name:QUALITY MOBILE LAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LAB DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LUCRECE
Authorized Official - Middle Name:
Authorized Official - Last Name:NSOESIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-825-0852
Mailing Address - Street 1:519 ROSZEL WAY
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:MD
Mailing Address - Zip Code:21001-2932
Mailing Address - Country:US
Mailing Address - Phone:443-825-0852
Mailing Address - Fax:
Practice Address - Street 1:519 ROSZEL WAY
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:MD
Practice Address - Zip Code:21001-2932
Practice Address - Country:US
Practice Address - Phone:443-825-0852
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-12
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory