=====================================================
General NPI Number Information
=====================================================
NPI Number | 1790600997
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CITY MED LABORATORY INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/13/2026
-----------------------------------------------------
Last Update Date | 08/13/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 14506 FRIAR ST
-----------------------------------------------------
City | VAN NUYS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91411-2308
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-447-6573
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 14506 FRIAR ST
-----------------------------------------------------
City | VAN NUYS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 91411-2308
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 818-447-6573
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | EMIN AMYAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 818-447-6573
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 291U00000X
-----------------------------------------------------
Taxonomy Name | Clinical Medical Laboratory
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------