MEDICARE: VALLEY VIEW DIAGNOSTIC LAB INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	291U00000X	Clinical Medical Laboratory	CLF1166	CA

General Provider Information

NPI Number	:	1972600625
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VALLEY VIEW DIAGNOSTIC LAB INC

Provider Business Mailing Address
First Line	:	7251 OWENSMOUTH AVE
Second Line	:
City	:	CANOGA PARK
State	:	CA
Zip	:	91303-1517
Country	:	US
Telephone Number	:	818-313-8959
Fax Number	:

Provider Business Practice Location Address
First Line	:	7251 OWENSMOUTH AVE
Second Line	:
City	:	CANOGA PARK
State	:	CA
Zip	:	91303-1517
Country	:	US
Telephone Number	:	818-313-8959
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	SAMVEL ABADJIAN
Credential	:
Telephone Number	:	818-313-8959

Provider Enumeration Date	:	09/17/2006
Last Update Date	:	08/22/2020

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