Healthcare Provider Details

I. General information

NPI: 1679408207
Provider Name (Legal Business Name): ASSURANCE MOBILE LAB SERVICE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1814 JESSICA DR
INDIANAPOLIS IN
46239-9797
US

IV. Provider business mailing address

1814 JESSICA DR
INDIANAPOLIS IN
46239-9797
US

V. Phone/Fax

Practice location:
  • Phone: 888-980-5227
  • Fax: 971-316-1896
Mailing address:
  • Phone: 888-980-5227
  • Fax: 971-316-1896

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. MARIA LA SHON TORRENCE
Title or Position: OWNER
Credential: REGISTERED NURSE
Phone: 888-980-5227