Organization
ALLSTATE INVESTMENT REALTY INC
Active
Other names
Northwest Lab
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MIKE AVEDISSIAN (PRESIDENT)
(818) 752-6030
Entity
Organization
Contact information
Practice address
10133 RIVERSIDE DR, TOLUCA LAKE, CA 91602-2533
(818) 752-6030
(818) 752-6033
Mailing address
10133 RIVERSIDE DR, TOLUCA LAKE, CA 91602-2533
(818) 752-6030
(818) 752-6033
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
CLF10750
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LAB8782F
—
CA
Enumeration date
05/26/2006
Last updated
01/11/2013
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