Healthcare Provider Details

I. General information

NPI: 1407808520
Provider Name (Legal Business Name): UNITED HEALH LABORATORIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/17/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5608 ROSEMEAD BLVD
TEMPLE CITY CA
91780-1842
US

IV. Provider business mailing address

5608 ROSEMEAD BLVD
TEMPLE CITY CA
91780-1842
US

V. Phone/Fax

Practice location:
  • Phone: 626-237-6623
  • Fax:
Mailing address:
  • Phone: 626-237-6623
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License NumberCLF10915
License Number StateCA

VIII. Authorized Official

Name: MR. MIKHAIL ERENKOV
Title or Position: PRESIDENT
Credential:
Phone: 626-237-6623