Healthcare Provider Details

I. General information

NPI: 1730018680
Provider Name (Legal Business Name): ELS XPRESS MOBILE PHLEBOTOMY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5701 MANZANITA AVE APT 75
CARMICHAEL CA
95608-6519
US

IV. Provider business mailing address

5701 MANZANITA AVE APT 75
CARMICHAEL CA
95608-6519
US

V. Phone/Fax

Practice location:
  • Phone: 916-537-0144
  • Fax:
Mailing address:
  • Phone: 916-537-0144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number
License Number State

VIII. Authorized Official

Name: EARNEISHA SMITH
Title or Position: OWNER
Credential: CPT
Phone: 916-537-0144