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General NPI Number Information
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NPI Number | 1497802466
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Entity Type | Organization
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Legal Business Name | BIXBY CLINICAL LABORATORY, INC.
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 04/22/2008
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Provider Practice Location Address
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Address Line | 10523 BURBANK BLVD #102
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91601-2233
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Country | US
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Telephone | 818-508-9603
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Fax | 818-508-9206
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Provider Business Mailing Address
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Address Line | 10523 BURBANK BLVD #102
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91601-2233
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Country | US
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Telephone | 818-508-9603
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Fax | 818-508-9206
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Authorized Official
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Title or Position | OWNER
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Name | MRS. MARINA KARAMYAN
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Credential |
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Telephone | 818-508-9603
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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 | CLF333543
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License Number State | CA
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