Provider Demographics
NPI:1073367389
Name:MNM LABORATORY CONSULTING, LLC
Entity type:Organization
Organization Name:MNM LABORATORY CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MASHUD
Authorized Official - Middle Name:
Authorized Official - Last Name:OGUNLAJA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:424-999-8698
Mailing Address - Street 1:32067 AUGUST WOODS WAY
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77385-2029
Mailing Address - Country:US
Mailing Address - Phone:310-418-6535
Mailing Address - Fax:
Practice Address - Street 1:110 CYPRESS STATION DR STE 285
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-1689
Practice Address - Country:US
Practice Address - Phone:424-999-8698
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-15
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory