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NPI Code Detail

MEDICARE: NOVATECH LC LAB LLC

MEDICARE: NOVATECH LC LAB LLC
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
1332B00000XDurable Medical Equipment & Medical Supplies

General Provider Information

NPI Number : 1619856804
Entity Type Code : Organization
Provider Name (Legal Business Name) : NOVATECH LC LAB LLC
Provider Business Mailing Address
First Line : 3625 W BARSTOW AVE APT 109
Second Line :
City : FRESNO
State : CA
Zip : 93711-6671
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3625 W BARSTOW AVE APT 109
Second Line :
City : FRESNO
State : CA
Zip : 93711-6671
Country : US
Telephone Number : 559-890-1010
Fax Number :
Authorized Official
Title or Position : CEO
Name : RAJENDER KUMAR
Credential :
Telephone Number : 559-890-1010
Provider Enumeration Date : 09/01/2025
Last Update Date : 09/01/2025

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Directions to “NOVATECH LC LAB LLC ” Practice Location

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