Provider Demographics
NPI:1427785088
Name:LABS R US MOBILE PHLEBOTOMY SERVICIES LLC.
Entity type:Organization
Organization Name:LABS R US MOBILE PHLEBOTOMY SERVICIES LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CERTIFIED PHLEBOTOMY TECHNICIAN
Authorized Official - Prefix:
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:MELISSA
Authorized Official - Last Name:BAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:CPT
Authorized Official - Phone:610-335-6724
Mailing Address - Street 1:6815 CLOVER LN
Mailing Address - Street 2:
Mailing Address - City:UPPER DARBY
Mailing Address - State:PA
Mailing Address - Zip Code:19082-5302
Mailing Address - Country:US
Mailing Address - Phone:610-335-6724
Mailing Address - Fax:267-500-9889
Practice Address - Street 1:6815 CLOVER LN
Practice Address - Street 2:
Practice Address - City:UPPER DARBY
Practice Address - State:PA
Practice Address - Zip Code:19082-5302
Practice Address - Country:US
Practice Address - Phone:610-335-6724
Practice Address - Fax:267-500-9889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-03
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1913919082OtherTHE ENHANCED CARE PPO (ECP)
PA1913919082Medicaid