Organization
KESTER DIAGNOSTIC LAB, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HARRY BUBUSHYAN (MANAGER)
(818) 988-6600
Entity
Organization
Contact information
Practice address
6817 KESTER AVE, VAN NUYS, CA 91405-3716
(818) 988-6600
(818) 988-6601
Mailing address
6817 KESTER AVE, VAN NUYS, CA 91405-3716
(818) 988-6600
(818) 988-6601
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
CLF ID 00340402
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CLF ID 00340402
CLIA ID 05D2025446
CA
Enumeration date
03/14/2012
Last updated
03/14/2012
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