Healthcare Provider Details
I. General information
NPI: 1780476713
Provider Name (Legal Business Name): NOBLE MEDLAB L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/17/2025
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
411 DORCHESTER AVE STE PURPLE1
CAMBRIDGE MD
21613-2421
US
IV. Provider business mailing address
411 DORCHESTER AVE STE PURPLE1
CAMBRIDGE MD
21613-2421
US
V. Phone/Fax
- Phone: 410-463-1495
- Fax: 410-835-4995
- Phone: 410-463-1495
- Fax: 410-835-4995
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 291U00000X |
| Taxonomy | Clinical Medical Laboratory |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
KIAIRA
MAJOR
Title or Position: OWNER
Credential:
Phone: 410-330-7559