Provider Demographics
NPI:1518699008
Name:SUFFICIENT MOBILE LABS
Entity Type:Organization
Organization Name:SUFFICIENT MOBILE LABS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MOBILE PHLEBOTOMIST
Authorized Official - Prefix:
Authorized Official - First Name:SPONTANEOUS
Authorized Official - Middle Name:
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-243-5416
Mailing Address - Street 1:91 MARCONI AVE
Mailing Address - Street 2:
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06606-6020
Mailing Address - Country:US
Mailing Address - Phone:203-243-5416
Mailing Address - Fax:
Practice Address - Street 1:91 MARCONI AVE
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06606-6020
Practice Address - Country:US
Practice Address - Phone:203-243-5416
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-24
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty