| NPI | 1013912518 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROMAN SHAYEVICH President 818-783-6107 |
| Organization Subpart ? | No |
| Primary Taxonomy | 291U00000X Clinical Medical Laboratory (Licence: CA 134513-57) |
| Enumeration Date | 2005-06-20 |
| Last Update Date | 2020-08-22 |