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General NPI Number Information
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NPI Number | 1154600575
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Entity Type | Organization
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Legal Business Name | LABORATORY OF WEST
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Dates
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Enumeration Date | 08/16/2011
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Last Update Date | 08/16/2011
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Provider Practice Location Address
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Address Line | 800 S VICTORY BLVD #107
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City | BURBANK
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State | CA
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Zip | 91502-2427
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Country | US
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Telephone | 818-478-1947
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Fax | 818-478-1279
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Provider Business Mailing Address
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Address Line | 800 S VICTORY BLVD #107
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City | BURBANK
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State | CA
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Zip | 91502-2427
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Country | US
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Telephone | 818-478-1947
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Fax | 818-478-1279
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Authorized Official
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Title or Position | PARTNER
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Name | ARMAN VOSKERCHYAN
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Credential |
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Telephone | 818-478-1947
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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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