Organization
CHROME RESIDENTIAL, LLC
Active
Other names
Chrome Health
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB R BENCHLOUCH HARAR (OWNER)
(323) 949-6350
Entity
Organization
Contact information
Practice address
14030 DAVANA TER, SHERMAN OAKS, CA 91423-4244
(323) 949-6350
Mailing address
14030 DAVANA TER, SHERMAN OAKS, CA 91423-4244
(323) 949-6350
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D2271473
CLIA
—
01
—
CB406422
MEDICARE
CA
01
—
CLR-90008102
CDPH - CLINICAL AND PUBLIC HEALTH LABORATORY LICENSE
CA
Enumeration date
06/02/2022
Last updated
06/16/2023
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