Organization
AVANTE DIAGNOSTIC LABORATORY LLC
Active
Organization
AVANTE DIAGNOSTIC LABORATORY LLC
Active
Other names
Avante Diagnostic Laboratory
Organization subpart
No
Provider details
NPI number
Authorized official
SHEILA BUSHERI (PRESIDENT / CEO)
(818) 324-3780
Entity
Organization
Contact information
Practice address
6704 VALJEAN AVE, VAN NUYS, CA 91406-5818
(877) 883-8783
(818) 849-5442
Mailing address
6704 VALJEAN AVE, VAN NUYS, CA 91406-5818
(877) 883-8783
(818) 849-5442
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D2244908
CLIA
CA
01
—
CDF-90005401
CDPH
CA
Enumeration date
11/02/2022
Last updated
11/02/2022
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