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General NPI Number Information
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NPI Number | 1386912566
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Entity Type | Organization
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Legal Business Name | PCT MOBLIE LABS INC
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Dates
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Enumeration Date | 12/02/2011
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Last Update Date | 12/02/2011
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Provider Practice Location Address
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Address Line | 4489 HOAGLAND BLACKSTUB RD
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City | CORTLAND
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State | OH
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Zip | 44410-9573
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Country | US
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Telephone | 330-501-8588
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Fax | 330-306-5123
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Provider Business Mailing Address
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Address Line | 4489 HOAGLAND BLACKSTUB RD
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City | CORTLAND
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State | OH
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Zip | 44410-9573
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Country | US
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Telephone | 330-501-8588
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Fax | 330-306-5123
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Authorized Official
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Title or Position | PRESIDENT
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Name | CHRISTOPHER F LOMBARD
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Credential | RN
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Telephone | 330-501-8588
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 36D2016180
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License Number State | OH
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