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NPI 1073268322

NPI 1073268322 : STAR MEDICAL LABORATORY INC : SUN VALLEY, CA

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General NPI Number Information
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    NPI Number           |    1073268322
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    Entity Type          |    Organization 
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    Legal Business Name  |    STAR MEDICAL LABORATORY INC 
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Dates
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    Enumeration Date     |    02/15/2022
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    Last Update Date     |    02/15/2022
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Provider Practice Location Address
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    Address Line         |    8588 TELFAIR AVE STE B 
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    City                 |    SUN VALLEY
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    State                |    CA
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    Zip                  |    91352-3145
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    Country              |    US
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    Telephone            |    818-394-9533
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    8588 TELFAIR AVE STE B 
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    City                 |    SUN VALLEY
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    State                |    CA
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    Zip                  |    91352-3145
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    Country              |    US
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    Telephone            |    818-394-9533
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    Fax                  |    
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Authorized Official
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    Title or Position    |    CEO
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    Name                 |    MS. OLGA  ZHEVLAKOVA 
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    Credential           |    
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    Telephone            |    818-394-9533
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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       |    
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    License Number State |    
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