Organization
HOOSHANG DALAVARIAN, INC
Active
Organization
HOOSHANG DALAVARIAN, INC
Active
Other names
SOUTHERN CALIFORNIA REFERENCE LABORATORY
Organization subpart
No
Provider details
NPI number
Authorized official
HOOSHANG DALAVARIAN PH.D (PRESIDENT)
(714) 285-2950
Entity
Organization
Contact information
Practice address
100 TUSTIN AVE, TUSTIN, CA 92780
(714) 285-2950
(714) 285-2960
Mailing address
100 TUSTIN AVE, TUSTIN, CA 92780
(714) 285-2950
(714) 285-2960
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
CLF 11532
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LAB55508F
—
CA
Enumeration date
07/07/2006
Last updated
11/28/2007
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