Provider Demographics
NPI:1619645405
Name:MOBILE LAB SOLUTIONS MN LLC
Entity Type:Organization
Organization Name:MOBILE LAB SOLUTIONS MN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ZYLKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:612-875-2843
Mailing Address - Street 1:7885 SUNNYSIDE RD
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55112-4337
Mailing Address - Country:US
Mailing Address - Phone:612-875-2843
Mailing Address - Fax:612-999-1590
Practice Address - Street 1:7885 SUNNYSIDE RD
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55112-4337
Practice Address - Country:US
Practice Address - Phone:612-875-2843
Practice Address - Fax:612-999-1590
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-06
Last Update Date:2021-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory