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General NPI Number Information
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NPI Number | 1043535263
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Entity Type | Organization
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Legal Business Name | ZIZI INC
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Dates
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Enumeration Date | 03/30/2010
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Last Update Date | 03/30/2010
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Provider Practice Location Address
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Address Line | 2360 CORPORATE CIR STE 100
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City | HENDERSON
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State | NV
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Zip | 89074-7722
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Country | US
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Telephone | 702-522-1491
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Fax | 800-586-3501
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Provider Business Mailing Address
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Address Line | 11201 S EASTERN AVE STE 210
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City | HENDERSON
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State | NV
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Zip | 89052-6201
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Country | US
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Telephone | 702-522-1491
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Fax | 800-586-3501
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANDREW UKLEJA
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Credential | M.D.
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Telephone | 702-522-1491
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 29D1088252
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License Number State | NV
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