Organization Active NPI

Mobile Diagnostic Laboratory, Inc.

  • Clinical Medical Laboratory
  • Pine Bluff, AR
National Provider Identifier
1992643597
Registry record updated Mar 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
MOBILE DIAGNOSTIC LABORATORY, INC.
Practice address
703 West Pullen Avenue
Pine Bluff, AR 71601-3441
Phone
(870) 433-0096
Fax
(870) 433-0686
NPI assigned
Mar 24, 2026
Organization subpart
Yes
Parent organization
MOBILE DIAGNOSTIC LABORATORY, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 24, 2026

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

Authorized official

Name
Dr. Joseph Howard Trotter, M.D.
Title
Director
Phone
(870) 433-0096

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

703 West Pullen Avenue
Pine Bluff, AR 71601-3441

Mailing address

703 West Pullen Avenue
Pine Bluff, AR 71601-3441
Phone (870) 433-0096

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
04D2254057Mobile Diagnostic Laboratory Inc703 West Pullen Street, Pine Bluff, AR 71601Certificate of waiverFeb 28, 2028

National Provider Directory

National Provider Directory
Part of
Mobile Diagnostic Laboratory Inc

NPI Registry JSON

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

{
    "created_epoch": "1774310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774310400000",
    "number": "1992643597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 WEST PULLEN AVENUE",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716013441",
            "telephone_number": "870-433-0096",
            "fax_number": "870-433-0686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 WEST PULLEN AVENUE",
            "city": "PINE BLUFF",
            "state": "AR",
            "postal_code": "716013441",
            "telephone_number": "870-433-0096",
            "fax_number": "870-433-0686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE DIAGNOSTIC LABORATORY, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MOBILE DIAGNOSTIC LABORATORY, INC.",
        "enumeration_date": "2026-03-24",
        "last_updated": "2026-03-24",
        "status": "A",
        "authorized_official_last_name": "TROTTER",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "HOWARD",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "870-433-0096",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pine Bluff, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.