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General NPI Number Information
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NPI Number | 1093649402
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Entity Type | Organization
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Legal Business Name | NOVALAB DIAGNOSTICS INC
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Dates
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Enumeration Date | 06/10/2026
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Last Update Date | 06/11/2026
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Provider Practice Location Address
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Address Line | 700 NICHOLAS BLVD
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City | ELK GROVE VLG
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State | IL
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Zip | 60007-2599
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Country | US
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Telephone | 818-282-6673
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Fax |
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Provider Business Mailing Address
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Address Line | 700 NICHOLAS BLVD
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City | ELK GROVE VLG
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State | IL
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Zip | 60007-2599
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Country | US
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Telephone | 818-282-6673
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | KAREN VARDUMYAN
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Credential |
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Telephone | 818-282-6673
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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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