Healthcare Provider Details

I. General information

NPI: 1043535263
Provider Name (Legal Business Name): ZIZI INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2010
Last Update Date: 03/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2360 CORPORATE CIR STE 100
HENDERSON NV
89074-7722
US

IV. Provider business mailing address

11201 S EASTERN AVE STE 210
HENDERSON NV
89052-6201
US

V. Phone/Fax

Practice location:
  • Phone: 702-522-1491
  • Fax: 800-586-3501
Mailing address:
  • Phone: 702-522-1491
  • Fax: 800-586-3501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number29D1088252
License Number StateNV

VIII. Authorized Official

Name: ANDREW UKLEJA
Title or Position: PRESIDENT
Credential: M.D.
Phone: 702-522-1491