Healthcare Provider Details

I. General information

NPI: 1790600997
Provider Name (Legal Business Name): CITY MED LABORATORY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14506 FRIAR ST
VAN NUYS CA
91411-2308
US

IV. Provider business mailing address

14506 FRIAR ST
VAN NUYS CA
91411-2308
US

V. Phone/Fax

Practice location:
  • Phone: 818-447-6573
  • Fax:
Mailing address:
  • Phone: 818-447-6573
  • Fax:

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: EMIN AMYAN
Title or Position: CEO
Credential:
Phone: 818-447-6573