Provider Demographics
NPI:1194109504
Name:EASY MOBILE LABS INC
Entity type:Organization
Organization Name:EASY MOBILE LABS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:LAFURGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-852-0302
Mailing Address - Street 1:149 SPACE PARK S
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-3123
Mailing Address - Country:US
Mailing Address - Phone:855-562-5227
Mailing Address - Fax:855-522-8726
Practice Address - Street 1:8417 CROSSLAND LOOP
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-8485
Practice Address - Country:US
Practice Address - Phone:855-562-5227
Practice Address - Fax:855-522-8726
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-15
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory