Organization
PREMIERE CLINICAL LABORATORY,INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACK AZAD M.D. (DIRECTOR/OWNER)
(323) 756-1317
Entity
Organization
Contact information
Practice address
11900 SOUTH AVALON BLVD., SUITE#100, LOS ANGELES, CA 90061-2837
(323) 756-1317
(323) 756-4015
Mailing address
11900 SOUTH AVALON BLVD., SUITE#100, LOS ANGELES, CA 90061-2837
(323) 756-1317
(323) 756-4015
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
CLF00321668
CA
Other
Enumeration date
10/27/2006
Last updated
05/18/2011
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