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General NPI Number Information
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NPI Number | 1497000509
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Entity Type | Organization
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Legal Business Name | AZRA LABS, INC.
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Dates
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Enumeration Date | 07/16/2012
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Last Update Date | 07/16/2012
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Provider Practice Location Address
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Address Line | 4136 LEGACY PKWY SUITE 110
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City | LANSING
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State | MI
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Zip | 48911-4265
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Country | US
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Telephone | 517-206-1388
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Fax |
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Provider Business Mailing Address
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Address Line | 2843 E GRAND RIVER AVE BOX 260
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City | EAST LANSING
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State | MI
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Zip | 48823-6722
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Country | US
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Telephone | 517-206-1388
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. ASHER JAVAID BASHIR
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Credential | J.D.
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Telephone | 517-206-1388
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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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Taxonomy #2
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Taxonomy Code | 335V00000X
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Taxonomy Name | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QS1200X
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Taxonomy Name | Sleep Disorder Diagnostic Clinic/Center
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License Number |
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License Number State |
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