PREMIER MOBILE LAB LLC (NPI# 1740744614) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740744614 |
| Entity Type | Organization |
| Organization Name | PREMIER MOBILE LAB LLC |
| Practice Address |
383 Fossil View Rd Las Cruces NM 88007-7176 |
| Mailing Address |
Po Box 155 Radium Springs NM 88054-0155 |
| Practice Telephone | 5755203254 |
| Mailing Telephone | 5755203254 |
| Enumeration Date | 2019-01-25 |
| Last Update Date | 2019-01-25 |
| Authorized Official Name | RANDALL DEAN WILCOX (CEO) |
| Authorized Official Telephone | 5755203254 |
| Authorized Official Credential | PHLEBOTOMY |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251E00000X | Home Health | Agencies | ||
| N | 305S00000X | Point of Service | Managed Care Organizations | ||
| N | 310500000X | Intermediate Care Facility, Mental Illness | Nursing & Custodial Care Facilities | ||
| N | 332800000X | Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy | Suppliers | ||
| Y | 291U00000X | Clinical Medical Laboratory | Laboratories |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 246RP1900X | 05 |
| Other Name | Type Code |
|---|---|
| Premier Mobile Lab LLC | Former Legal Business Name - Organization |
| Street Address |
383 FOSSIL VIEW RD |
| City | LAS CRUCES |
| State | NM |
| Zip Code | 88007-7176 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144592304 | Randall Dean Wilcox | Contractor | 383 Fossil View Rd, Las Cruces, NM 88007 | 2012-02-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952814196 | Debra G Hanus | Registered Nurse | 12325 Fort Mcrae Rd., Las Cruces, NM 88007 | 2017-11-09 |
| 1730698309 | Equine Assisted Programs of Southern New Mexico LLC | Clinic/Center | 190 Providence Road, Las Cruces, NM 88007 | 2017-09-26 |
| 1952841926 | Kimberly Danielle Diaz | Marriage & Family Therapist | 471 Alvillar Rd, Las Cruces, NM 88007 | 2017-02-24 |
| 1326420951 | Juan Mendoza | Psychologist | 715 E. Idaho, Las Cruces, NM 88007 | 2015-06-19 |
| 1801206974 | Sonnie Michelle Sanchez | Case Manager/Care Coordinator | 2211 N. Valley Dr., Las Cruces, NM 88007 | 2014-04-29 |
| 1932528171 | Carrie A Jones | Case Manager/Care Coordinator | 2211 N. Valley, Las Cruces, NM 88007 | 2014-04-15 |
| 1881015402 | Tony Trevino | Case Manager/Care Coordinator | 660 Copa Lane, Las Cruces, NM 88007 | 2013-12-27 |
| 1982025508 | Gilbert L Barela | Case Manager/Care Coordinator | 440 Helens Place, Las Cruces, NM 88007 | 2013-12-27 |
| 1497176010 | Heather Barela | Case Manager/Care Coordinator | 305 Windchime Lane, Las Cruces, NM 88007 | 2013-12-27 |
| 1962833194 | Sylvia Trevino | Case Manager/Care Coordinator | 660 Copa Ln., Las Cruces, NM 88007 | 2013-12-13 |
| Find all providers in zip 88007 | ||||
| Taxonomy Code | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821381773 | Alethea Laboratories Inc | Clinical Medical Laboratory | 410 E. Foster Road, Las Cruces, NM 88005-3209 | 2011-05-25 |
| 1083946222 | Metwest Inc | Clinical Medical Laboratory | 1121 Mall Dr, Las Cruces, NM 88011-8102 | 2010-02-12 |
| 1609106756 | Clinical Testing Laboratories, Inc. | Clinical Medical Laboratory | 3655 Research Dr, Msc3arp, Box 30001, Las Cruces, NM 88003-1239 | 2010-01-12 |
| 1093337586 | Vangaurd Genetics, LLC | Clinical Medical Laboratory | 3655 Research Drive, Msc3arp, Genesis-b, Las Cruces, NM 88003 | 2020-05-07 |
| 1083234264 | Las Cruces Medical Center LLC | Clinical Medical Laboratory | 4311 E Lohman Ave, Las Cruces, NM 88011-8255 | 2020-04-17 |
| 1003932773 | Rio Grande Medical Group | Clinical Medical Laboratory | 4351 E Lohman Ave, Suite 301, Las Cruces, NM 88011-8259 | 2007-03-22 |
| 1366511610 | El Paso Pathology Laboratory Lp | Clinical Medical Laboratory | 4351 E Lohman Ave, #409, Las Cruces, NM 88011-8259 | 2006-11-08 |
| 1265468698 | Pathology Associates, Pa | Clinical Medical Laboratory | 2450 S Telshor Blvd, Las Cruces, NM 88011-5069 | 2006-06-25 |
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|---|---|---|---|---|
| 1932727088 | Disabled Veterans Reference Labs Inc | Clinical Medical Laboratory | 5400 Gibson Blvd Se Ste 20, Albuquerque, NM 87108-5182 | 2020-07-06 |
| 1407411762 | Ron Smock | Clinical Medical Laboratory | 4213 Montgomery Blvd Ne, Albuquerque, NM 87109-1103 | 2019-05-02 |
| 1780059717 | Southwest Labs LLC | Clinical Medical Laboratory | 4261 Balloon Park Rd Ne, Albuquerque, NM 87109-5802 | 2015-12-02 |
| 1669858700 | Nex Step, Inc. | Clinical Medical Laboratory | 518 Old Santa Fe Trl, Suite 1, Pmb 220, Santa Fe, NM 87505-0398 | 2015-07-30 |
| 1225424567 | Recovery Services of New Mexico | Clinical Medical Laboratory | 5659 Jefferson St Ne, Suite E, Albuquerque, NM 87109-3458 | 2015-04-14 |
| 1255725339 | Ann Owens Tafoya | Clinical Medical Laboratory | 1301 Kentucky St Se, Albuquerque, NM 87108-5108 | 2015-03-26 |
| 1740615855 | Elizabeth Amanda Stenger | Clinical Medical Laboratory | 10444 Calle Avila Nw, Albuquerque, NM 87114-1804 | 2013-09-08 |
| 1467783753 | Matrix Genomics, Inc. | Clinical Medical Laboratory | 3900 Paseo Del Sol, Santa Fe, NM 87507-4072 | 2010-01-26 |
| 1659607760 | Northern Nm Vascular Lab | Clinical Medical Laboratory | 7555 Enchanted Hls Dr Ne, Suite 210, Rio Rancho, NM 87144-8625 | 2009-10-23 |
| 1184957391 | Lovelace Health Systems Inc. Dba S.e.d. Medical Laboratories-farmingto | Clinical Medical Laboratory | 724 W Animas St, Farmington, NM 87401-5617 | 2009-09-08 |
| Find all providers with the same taxonomy | ||||
| City | LAS CRUCES |
| Zip Code | 88007 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.