Organization
100 PLAZA CLINICAL LAB INC
Active
Organization
100 PLAZA CLINICAL LAB INC
Active
Other names
100 PLAZA CLINICAL LAB
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BAHRAM PARSA M.D., PH.D. (DIRECTOR)
(310) 208-0099
Entity
Organization
Contact information
Practice address
100 UCLA MEDICAL PLZ, SUITE #245, LOS ANGELES, CA 90024-6970
(310) 208-0099
(310) 208-0963
Mailing address
100 UCLA MEDICAL PLZ, SUITE #245, LOS ANGELES, CA 90024-6970
(310) 208-0099
(310) 208-0963
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
CLF519
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LAB58794F
—
CA
Enumeration date
08/30/2006
Last updated
03/27/2009
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