Healthcare Provider Details

I. General information

NPI: 1992617492
Provider Name (Legal Business Name): MLAB COLLECT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2026
Last Update Date: 09/19/2026
Certification Date: 09/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 HILLPOINTE WAY
DODGE CITY KS
67801-2758
US

IV. Provider business mailing address

2100 HILLPOINTE WAY
DODGE CITY KS
67801-2758
US

V. Phone/Fax

Practice location:
  • Phone: 620-255-3028
  • Fax:
Mailing address:
  • Phone: 620-255-3028
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: NYMPHA MARVILLA
Title or Position: FOUNDER/ OWNER
Credential:
Phone: 620-255-3028