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General NPI Number Information
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NPI Number | 1376256461
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Entity Type | Organization
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Legal Business Name | WEST COAST LAB SCREENING
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Dates
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Enumeration Date | 01/04/2023
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Last Update Date | 01/04/2023
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Provider Practice Location Address
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Address Line | 4100 W ALAMEDA AVE # 315
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City | BURBANK
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State | CA
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Zip | 91505-4195
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Country | US
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Telephone | 800-491-0048
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Fax | 323-983-8799
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Provider Business Mailing Address
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Address Line | 4100 W ALAMEDA AVE # 315
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City | BURBANK
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State | CA
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Zip | 91505-4195
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Country | US
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Telephone | 800-491-0048
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Fax | 323-983-8799
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Authorized Official
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Title or Position | COO
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Name | MYRON RICHARD BANKS
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Credential |
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Telephone | 323-308-9717
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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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