Organization
21ST CENTURY DIAGNOSTIC LABORATORY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HASMIK MELKUMYAN CLS (SERCRETARY)
(323) 660-9480
Entity
Organization
Contact information
Practice address
121 N VICTORY BLVD, BURBANK, CA 91502-1837
(323) 660-9480
Mailing address
121 N VICTORY BLVD, BURBANK, CA 91502-1837
(323) 660-9480
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
05D0956168
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LAB56168F
—
CA
Enumeration date
07/31/2006
Last updated
08/03/2022
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