Healthcare Provider Details

I. General information

NPI: 1972411403
Provider Name (Legal Business Name): BIOTRACE LABS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8216 LANKERSHIM BLVD STE 16
NORTH HOLLYWOOD CA
91605-1699
US

IV. Provider business mailing address

8216 LANKERSHIM BLVD STE 16
NORTH HOLLYWOOD CA
91605-1699
US

V. Phone/Fax

Practice location:
  • Phone: 747-236-5550
  • Fax: 747-236-5005
Mailing address:
  • Phone: 747-236-5550
  • Fax: 747-236-5005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MANIK KALASHYAN
Title or Position: CEO
Credential:
Phone: 747-236-5550