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General NPI Number Information
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NPI Number | 1831449859
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Entity Type | Organization
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Legal Business Name | GENX LABORATORIES, INC.
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Dates
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Enumeration Date | 09/18/2012
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Last Update Date | 09/18/2012
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Provider Practice Location Address
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Address Line | 3057 ROSWELL ST
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City | LOS ANGELES
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State | CA
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Zip | 90065-2213
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Country | US
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Telephone | 323-344-8834
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Fax | 323-344-8624
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Provider Business Mailing Address
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Address Line | 3057 ROSWELL ST
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City | LOS ANGELES
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State | CA
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Zip | 90065-2213
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Country | US
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Telephone | 323-344-8834
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Fax | 323-344-8624
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Authorized Official
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Title or Position | CEO
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Name | MR. TIGRAN AZATIAN
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Credential |
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Telephone | 213-910-1040
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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 | CLF00341935
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License Number State | CA
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