Organization
SONIC LABZONE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NIKOLAY AGISHEV (PRESIDENT)
(318) 344-9101
Entity
Organization
Contact information
Practice address
2533 BERT KOUNS INDUSTRIAL LOOP, SUITE 217, SHREVEPORT, LA 71118-3158
(318) 344-9101
Mailing address
6741 VAN NUYS BLVD, SUITE 207, VAN NUYS, CA 91405-4630
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
10/24/2007
Last updated
10/24/2007
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