Organization
PACIFIC CLINICAL LABORATORIES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DMITRY Y IVANOV (PRESIDENT)
(310) 246-0025
Entity
Organization
Contact information
Practice address
9675 BRIGHTON WAY, B200, BEVERLY HILLS, CA 90210-5144
(310) 246-0025
Mailing address
9675 BRIGHTON WAY, BEVERLY HILLS, CA 90210-5144
(310) 246-0025
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
CLF10883
CA
Other
Enumeration date
11/13/2006
Last updated
08/22/2020
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