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General NPI Number Information
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NPI Number | 1679759211
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Entity Type | Organization
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Legal Business Name | CYCLOSPORINE TESTING LABS
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Dates
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Enumeration Date | 01/14/2008
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Last Update Date | 05/15/2008
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Provider Practice Location Address
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Address Line | 21018 OSBORNE ST STE 3
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City | CANOGA PARK
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State | CA
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Zip | 91304-1736
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Country | US
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Telephone | 800-295-9495
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Fax |
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Provider Business Mailing Address
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Address Line | 18621 KNAPP ST
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City | NORTHRIDGE
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State | CA
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Zip | 91324-3103
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Country | US
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Telephone | 800-295-9495
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. HOMER BHATT
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Credential |
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Telephone | 800-295-9495
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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 | CLF10194
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License Number State | CA
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