Provider Demographics
NPI:1841067345
Name:SYNERGY MOBILE LAB LTD
Entity type:Organization
Organization Name:SYNERGY MOBILE LAB LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:PROF
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:RPT, CMAS, RMA
Authorized Official - Phone:445-206-2025
Mailing Address - Street 1:917 ARCH ST
Mailing Address - Street 2:408
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-2446
Mailing Address - Country:US
Mailing Address - Phone:445-206-2025
Mailing Address - Fax:
Practice Address - Street 1:917 ARCH ST
Practice Address - Street 2:408
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-2446
Practice Address - Country:US
Practice Address - Phone:445-206-2025
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-06
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes291U00000XLaboratoriesClinical Medical LaboratoryGroup - Multi-Specialty