NPIMap

Organization Active NPI

My Mobile Lab LLC

  • Clinical Medical Laboratory
  • Indianapolis, IN
National Provider Identifier
1275154841
Registry record updated May 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
MY MOBILE LAB LLC
Practice address
429 E Vermont St Ste 110
Indianapolis, IN 46202-3685
Phone
(317) 559-0950
Fax
(317) 936-3028
NPI assigned
May 5, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Steve Martin
Title
Ceo
Phone
(317) 670-6635

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

429 E Vermont St Ste 110
Indianapolis, IN 46202-3685

Mailing address

PO Box 586
Galloway, OH 43119-0586
Phone (765) 969-7841

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1588636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1588636800000",
    "number": "1275154841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 586",
            "city": "GALLOWAY",
            "state": "OH",
            "postal_code": "431190586",
            "telephone_number": "765-969-7841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "429 E VERMONT ST STE 110",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462023685",
            "telephone_number": "317-559-0950",
            "fax_number": "317-936-3028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY MOBILE LAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-05",
        "last_updated": "2020-05-05",
        "certification_date": "2020-05-05",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "317-670-6635"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.