Healthcare Provider Details

I. General information

NPI: 1275447757
Provider Name (Legal Business Name): BURBANK LABORATORY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

422 N VARNEY ST STE A
BURBANK CA
91502-1732
US

IV. Provider business mailing address

422 N VARNEY ST STE A
BURBANK CA
91502-1732
US

V. Phone/Fax

Practice location:
  • Phone: 747-241-8167
  • Fax:
Mailing address:
  • Phone: 747-241-8167
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number
License Number StateNULL

VIII. Authorized Official

Name: ALLEN VARDANYAN
Title or Position: CEO
Credential:
Phone: 747-241-8167