Provider Demographics
NPI:1700556958
Name:CHOICE MOBILE LAB LLC
Entity Type:Organization
Organization Name:CHOICE MOBILE LAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NAUJAI
Authorized Official - Middle Name:
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:CPT 1
Authorized Official - Phone:818-826-1065
Mailing Address - Street 1:25350 MAGIC MOUNTAIN PKWY STE 300
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-1356
Mailing Address - Country:US
Mailing Address - Phone:855-324-6673
Mailing Address - Fax:855-324-6673
Practice Address - Street 1:25350 MAGIC MOUNTAIN PKWY STE 300
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-1356
Practice Address - Country:US
Practice Address - Phone:855-324-6673
Practice Address - Fax:855-324-6673
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-19
Last Update Date:2021-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory