NPI 1740744614

Premier Mobile Lab LLC

Organisation Clinical Medical Laboratory Las Cruces, NM

Practice location

Address: 383 Fossil View Rd, Las Cruces, NM 88007-7176
Phone: (575) 520-3254
Mailing address: PO Box 155, Radium Springs, NM 88054-0155

Authorised official

Name: Randall Dean Wilcox
Title: Ceo
Phone: (575) 520-3254

Registered specialties (5)

Clinical Medical Laboratory Primary

Laboratories Taxonomy 291U00000X

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Home Health Agency

Agencies Taxonomy 251E00000X

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Point of Service

Managed Care Organizations Taxonomy 305S00000X

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Mental Illness Intermediate Care Facility

Nursing & Custodial Care Facilities Taxonomy 310500000X

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Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy

Suppliers Taxonomy 332800000X

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Registry record

NPI: 1740744614
Entity type: Organization
NPI issued: 25 Jan 2019
Record last updated: 25 Jan 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.