Legendary Mobile Phlebotomy & Lab LLC

Primary specialty

Phlebotomy TechnicianTaxonomy code 246RP1900X

Legal business name

LEGENDARY MOBILE PHLEBOTOMY & LAB LLC

Practice address

8317 West Mohave Street
Tolleson, AZ 85353-8959

Phone

(602) 632-3104

NPI assigned

May 12, 2025

Organization subpart

No

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

Authorized official

Name

Lakisha Hodge

Title

Owner

Phone

(602) 632-3104

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1747008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747008000000",
    "number": "1649060757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8317 WEST MOHAVE STREET",
            "city": "TOLLESON",
            "state": "AZ",
            "postal_code": "853538959",
            "telephone_number": "602-632-3104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8317 WEST MOHAVE STREET",
            "city": "TOLLESON",
            "state": "AZ",
            "postal_code": "853538959",
            "telephone_number": "602-632-3104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGENDARY MOBILE PHLEBOTOMY & LAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-12",
        "last_updated": "2025-05-12",
        "certification_date": "2025-05-12",
        "status": "A",
        "authorized_official_last_name": "HODGE",
        "authorized_official_first_name": "LAKISHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "602-632-3104"
    },
    "taxonomies": [
        {
            "code": "246RP1900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2025; 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.