Provider Demographics
NPI:1346082385
Name:LUNA MOBILE LAB SERVICES LLC
Entity type:Organization
Organization Name:LUNA MOBILE LAB SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:ANGELICA
Authorized Official - Middle Name:DENISSE
Authorized Official - Last Name:ACEVEDO ARREOLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-519-8120
Mailing Address - Street 1:9030 35TH AVE SW STE 100-1005
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98126-3821
Mailing Address - Country:US
Mailing Address - Phone:206-519-8120
Mailing Address - Fax:
Practice Address - Street 1:9030 35TH AVE SW STE 100-1005
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98126-3821
Practice Address - Country:US
Practice Address - Phone:206-519-8120
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-11
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty