MEDICARE: SIRONA LAB DIAGNOSTICS INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	291U00000X	Clinical Medical Laboratory

General Provider Information

NPI Number	:	1356951040
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SIRONA LAB DIAGNOSTICS INC

Provider Business Mailing Address
First Line	:	11755 VICTORY BLVD STE 108
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91606-3461
Country	:	US
Telephone Number	:	747-444-1940
Fax Number	:

Provider Business Practice Location Address
First Line	:	11755 VICTORY BLVD STE 108
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91606-3461
Country	:	US
Telephone Number	:	747-444-1940
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	RUZAN ASATRYAN
Credential	:
Telephone Number	:	818-599-8444

Provider Enumeration Date	:	08/06/2020
Last Update Date	:	08/06/2020

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