Organization
HOME LAB SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VLADYSLAV BEZRUCHKO (OWNER)
14152992225
Entity
Organization
Contact information
Practice address
2205 POST ST, SAN FRANCISCO, CA 94115-3427
(415) 299-2225
(415) 931-0905
Mailing address
1554 19TH AVE, SAN FRANCISCO, CA 94122-3417
(141) 529-9222
(415) 931-0905
Taxonomy
Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
394809
BUSINESS CERTIFICATE #
CA
Enumeration date
12/19/2006
Last updated
08/22/2020
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