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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