Provider Demographics
NPI:1386912566
Name:PCT MOBLIE LABS INC
Entity type:Organization
Organization Name:PCT MOBLIE LABS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:F
Authorized Official - Last Name:LOMBARD
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:330-501-8588
Mailing Address - Street 1:4489 HOAGLAND BLACKSTUB RD
Mailing Address - Street 2:
Mailing Address - City:CORTLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44410-9573
Mailing Address - Country:US
Mailing Address - Phone:330-501-8588
Mailing Address - Fax:330-306-5123
Practice Address - Street 1:4489 HOAGLAND BLACKSTUB RD
Practice Address - Street 2:
Practice Address - City:CORTLAND
Practice Address - State:OH
Practice Address - Zip Code:44410-9573
Practice Address - Country:US
Practice Address - Phone:330-501-8588
Practice Address - Fax:330-306-5123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-02
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36D2016180291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory