| Organization Name: | ACUTE PHLEBOTOMY MOBILE SPECIMEN COLLECTION SERVICE |
| NPI Number: | 1013376185 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MALCOLM MANDELA LEE (MEDICAL TECHNOLOGIST) |
| Mailing Address: | 930 White Oak Ln University Park |
| State: | IL US |
| Postal Code: | 604843007 |
| Phone Number: | 7087133729 |
| Fax Number: | |
| NPI Enumeration Date: | 02/18/2016 |
| NPI Last Update Date: | 02/18/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 246QM0706X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
| Taxonomy Classification: | Spec/Tech, Pathology |
| Taxonomy Specialization: | Medical Technologist |
| Taxonomy Definition: | |