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General NPI Number Information
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NPI Number | 1093064297
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Entity Type | Organization
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Legal Business Name | UNIVERSAL TOXICOLOGY SERVICES
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Dates
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Enumeration Date | 09/04/2012
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Last Update Date | 09/04/2012
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Provider Practice Location Address
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Address Line | 18375 VENTURA BLVD SUITE 642
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City | TARZANA
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State | CA
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Zip | 91356
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Country | US
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Telephone | 818-990-0260
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Fax |
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Provider Business Mailing Address
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Address Line | 18375 VENTURA BLVD SUITE 642
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City | TARZANA
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State | CA
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Zip | 91356
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | COO
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Name | MATTHEW WALK
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Credential | PHARM D
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Telephone | 310-251-7734
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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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