Provider Demographics
NPI:1679054019
Name:MOBILAB EXPRESS, INC.
Entity Type:Organization
Organization Name:MOBILAB EXPRESS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CERTIFIED PHLEBOTOMIST
Authorized Official - Prefix:MISS
Authorized Official - First Name:CAPRIA
Authorized Official - Middle Name:D
Authorized Official - Last Name:GRIMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-852-9085
Mailing Address - Street 1:908 WILLIAM EDMONDSON ST
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2877
Mailing Address - Country:US
Mailing Address - Phone:615-852-9085
Mailing Address - Fax:
Practice Address - Street 1:908 WILLIAM EDMONDSON ST
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2877
Practice Address - Country:US
Practice Address - Phone:615-389-0765
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-23
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty
No302R00000XManaged Care OrganizationsHealth Maintenance Organization