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General NPI Number Information
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NPI Number | 1437098076
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Entity Type | Organization
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Legal Business Name | FAST-TRAK MOBILE LAB LLC
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Dates
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Enumeration Date | 03/27/2026
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Last Update Date | 03/27/2026
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Provider Practice Location Address
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Address Line | 8465 KEYSTONE XING STE 1152553
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City | INDIANAPOLIS
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State | IN
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Zip | 46240-4355
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Country | US
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Telephone | 765-217-1311
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Fax | 317-961-6600
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Provider Business Mailing Address
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Address Line | 8465 KEYSTONE XING STE 1152553
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City | INDIANAPOLIS
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State | IN
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Zip | 46240-4355
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Country | US
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Telephone | 765-217-1311
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Fax | 317-961-6600
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Authorized Official
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Title or Position | CIO
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Name | STEFFANIE ANN HANNAH
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Credential | CCMA, CPT
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Telephone | 765-217-1311
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 247ZC0005X
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Taxonomy Name | Clinical Laboratory Director (Non-physician)
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License Number |
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License Number State |
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