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General NPI Number Information
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NPI Number | 1215207923
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Entity Type | Organization
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Legal Business Name | CALIFORNIA INDUSTRIAL LABORATIES, INC
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Dates
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Enumeration Date | 01/11/2012
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Last Update Date | 01/11/2012
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Provider Practice Location Address
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Address Line | 16530 VENTURA BLVD STE 411
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City | ENCINO
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State | CA
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Zip | 91436-5061
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Country | US
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Telephone | 818-855-2626
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Fax | 818-855-2627
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Provider Business Mailing Address
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Address Line | PO BOX 261714
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City | ENCINO
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State | CA
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Zip | 91426-1714
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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 |
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Telephone | 818-855-2626
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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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