Provider Demographics
NPI:1851723563
Name:GO LAB MOBILE, LLC
Entity Type:Organization
Organization Name:GO LAB MOBILE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MILYNNDA
Authorized Official - Middle Name:G
Authorized Official - Last Name:ISLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-632-7827
Mailing Address - Street 1:105 NORTH AVALON DRIVE
Mailing Address - Street 2:
Mailing Address - City:WINTERSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43953
Mailing Address - Country:US
Mailing Address - Phone:740-632-7827
Mailing Address - Fax:
Practice Address - Street 1:105 NORTH AVALON DRIVE
Practice Address - Street 2:
Practice Address - City:WINTERSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43953
Practice Address - Country:US
Practice Address - Phone:740-632-7827
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-05
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty