Provider Demographics
NPI:1578393757
Name:MOBILE LABORATORY SOLUTIONS
Entity type:Organization
Organization Name:MOBILE LABORATORY SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:GISELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:RIESCHICK
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:623-466-2731
Mailing Address - Street 1:1570 DESERT GOLD
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006-5814
Mailing Address - Country:US
Mailing Address - Phone:623-466-2731
Mailing Address - Fax:
Practice Address - Street 1:1570 DESERT GOLD
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-5814
Practice Address - Country:US
Practice Address - Phone:210-864-4888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-03
Last Update Date:2024-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0105XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology/Laboratory MedicineGroup - Single Specialty