Organization
BRIGHTSTAR LAB
Active
Other names
BRIGHTSTAR LAB
Organization subpart
No
Provider details
NPI number
Authorized official
AHSAN BASEER PHD., CLS (TECHNICAL SUPERVISOR)
(714) 493-1224
Entity
Organization
Contact information
Practice address
4634 SAN FERNANDO RD, GLENDALE, CA 91204
(747) 215-6633
Mailing address
4634 SAN FERNANDO RD, GLENDALE, CA 91204
(714) 493-1224
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D2304493
CLIA ID
CA
Enumeration date
07/17/2024
Last updated
07/17/2024
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