MEDICARE: MOBILAB LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1679453039
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOBILAB LLC

Provider Business Mailing Address
First Line	:	6392 MCLEOD DR STE 7
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-4417
Country	:	US
Telephone Number	:	725-300-0538
Fax Number	:	866-246-3093

Provider Business Practice Location Address
First Line	:	6392 MCLEOD DR STE 7
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-4417
Country	:	US
Telephone Number	:	725-300-0538
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	BENOIT MALVITZ
Credential	:
Telephone Number	:	725-300-0538

Provider Enumeration Date	:	09/05/2025
Last Update Date	:	09/16/2025

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Directions to “MOBILAB LLC ” Practice Location

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