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General NPI Number Information
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NPI Number | 1356794994
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Entity Type | Organization
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Legal Business Name | GENEX LABORATORY SERVICES,INC
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Dates
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Enumeration Date | 07/19/2016
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Last Update Date | 02/02/2017
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Provider Practice Location Address
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Address Line | 1301 N SAN FERNANDO BLVD
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City | BURBANK
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State | CA
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Zip | 91504-4236
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Country | US
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Telephone | 818-557-0004
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Fax | 818-557-0040
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Provider Business Mailing Address
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Address Line | 1301 N SAN FERNANDO BLVD
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City | BURBANK
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State | CA
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Zip | 91504-4236
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Country | US
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Telephone | 818-557-0004
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Fax | 818-557-0040
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Authorized Official
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Title or Position | OWNER
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Name | LEVON SARDARYAN
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Credential |
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Telephone | 81855700040
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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 | CLF00337819
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License Number State | CA
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