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General NPI Number Information
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NPI Number | 1427745066
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Entity Type | Organization
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Legal Business Name | INFINITY ONE MOBILE LABS LLC
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Dates
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Enumeration Date | 04/24/2023
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Last Update Date | 04/24/2023
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Provider Practice Location Address
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Address Line | 1403 SE HILLSIDE DR APT B
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City | OAK GROVE
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State | MO
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Zip | 64075-9417
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Country | US
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Telephone | 816-493-9436
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Fax |
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Provider Business Mailing Address
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Address Line | 1403 SE HILLSIDE DR APT B
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City | OAK GROVE
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State | MO
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Zip | 64075-9417
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Country | US
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Telephone | 816-493-9436
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | KRISTYN FRAZEE
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Credential |
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Telephone | 816-493-9436
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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 |
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License Number State |
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