Healthcare Provider Details
I. General information
NPI: 1497504500
Provider Name (Legal Business Name): ROCA LABORATORY INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/13/2024
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8588 TELFAIR AVE STE C
SUN VALLEY CA
91352-3145
US
IV. Provider business mailing address
8588 TELFAIR AVE STE C
SUN VALLEY CA
91352-3145
US
V. Phone/Fax
- Phone: 818-505-3603
- Fax:
- Phone: 818-505-3603
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 291U00000X |
| Taxonomy | Clinical Medical Laboratory |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RODRIGO
ALEXANDER
SERRANO
Title or Position: CEO
Credential:
Phone: 818-505-3603