Provider Demographics
NPI:1891455820
Name:MOBILE LAB SERVICES CO
Entity Type:Organization
Organization Name:MOBILE LAB SERVICES CO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:
Authorized Official - Last Name:ABUREALH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-896-2039
Mailing Address - Street 1:9449 ODELL AVE
Mailing Address - Street 2:
Mailing Address - City:BRIDGEVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60455-2115
Mailing Address - Country:US
Mailing Address - Phone:703-896-2039
Mailing Address - Fax:312-807-3550
Practice Address - Street 1:6108 S HARLEM AVE
Practice Address - Street 2:
Practice Address - City:SUMMIT
Practice Address - State:IL
Practice Address - Zip Code:60501-1626
Practice Address - Country:US
Practice Address - Phone:703-896-2039
Practice Address - Fax:312-807-3550
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-17
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory