Healthcare Provider Details

I. General information

NPI: 1396507141
Provider Name (Legal Business Name): JL MOBILE PHLEBOTOMY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2024
Last Update Date: 01/29/2024
Certification Date: 01/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 LAS PIEDRAS
RANCHO SANTA MARGARITA CA
92688-1627
US

IV. Provider business mailing address

PO BOX 80447
RANCHO SANTA MARGARITA CA
92688-0447
US

V. Phone/Fax

Practice location:
  • Phone: 949-302-7581
  • Fax:
Mailing address:
  • Phone: 949-460-3316
  • 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: JENNIFER LESLIE LUJAN
Title or Position: OWNER
Credential: PHLEBOTOMIST
Phone: 949-460-3316