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General NPI Number Information
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NPI Number | 1588241822
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Entity Type | Organization
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Legal Business Name | FIRST MOBILE LAB SERVICE
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Dates
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Enumeration Date | 03/24/2021
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Last Update Date | 03/24/2021
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Provider Practice Location Address
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Address Line | 2240 BOMBAY DR
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City | LAKE HAVASU CITY
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State | AZ
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Zip | 86404-2020
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Country | US
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Telephone | 928-486-5616
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Fax |
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Provider Business Mailing Address
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Address Line | 2240 BOMBAY DR
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City | LAKE HAVASU CITY
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State | AZ
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Zip | 86404-2020
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Country | US
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Telephone | 928-486-5616
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARCIE LYON
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Credential |
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Telephone | 928-486-5616
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246RP1900X
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Taxonomy Name | Phlebotomy Technician
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License Number |
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License Number State |
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