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General NPI Number Information
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NPI Number | 1619645405
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Entity Type | Organization
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Legal Business Name | MOBILE LAB SOLUTIONS MN LLC
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Dates
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Enumeration Date | 09/06/2021
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Last Update Date | 09/06/2021
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Provider Practice Location Address
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Address Line | 7885 SUNNYSIDE RD
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City | SAINT PAUL
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State | MN
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Zip | 55112-4337
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Country | US
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Telephone | 612-875-2843
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Fax | 612-999-1590
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Provider Business Mailing Address
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Address Line | 7885 SUNNYSIDE RD
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City | SAINT PAUL
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State | MN
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Zip | 55112-4337
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Country | US
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Telephone | 612-875-2843
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Fax | 612-999-1590
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Authorized Official
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Title or Position | OWNER
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Name | KATIE ZYLKA
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Credential |
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Telephone | 612-875-2843
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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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