Organization
CORONA PATHOLOGY CPS INC.
Active
Other names
Corona Pathology Services, Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HERSHEL TSIKMAN (OFFICER)
(818) 402-8060
Entity
Organization
Contact information
Practice address
4444 RIVERSIDE DR., SUITE 308, BURBANK, CA 91505-4073
(818) 566-1891
(818) 566-8834
Mailing address
4444 RIVERSIDE DR., SUITE 308, BURBANK, CA 91505-4073
(818) 566-1891
(818) 566-8834
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
BT-1006112
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D0879836
CLIA
CA
Enumeration date
09/18/2013
Last updated
02/10/2017
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