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General NPI Number Information
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NPI Number | 1992887814
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Entity Type | Organization
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Legal Business Name | ASHLEY CLINICAL DIAGNOSTIC LABORATORY INC
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Dates
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Enumeration Date | 10/19/2006
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Last Update Date | 08/14/2025
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Provider Practice Location Address
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Address Line | 5542 N FIGUEROA ST
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City | LOS ANGELES
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State | CA
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Zip | 90042-4120
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Country | US
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Telephone | 323-478-0801
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Fax | 323-259-1007
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Provider Business Mailing Address
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Address Line | 5542 N FIGUEROA ST
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City | LOS ANGELES
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State | CA
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Zip | 90042-4120
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Country | US
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Telephone | 323-478-0801
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Fax | 323-259-1007
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Authorized Official
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Title or Position | CEO
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Name | DR. MADHU B BANSAL
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Credential | PHD.
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Telephone | 323-478-0801
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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 | 05D0642478
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License Number State | CA
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