Organization
AVICENNA LABORATORY DIAGNOSTICS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PUNZALAN RUBIO (DIRECTOR)
(626) 201-9893
Entity
Organization
Contact information
Practice address
20011 VENTURA BLVD STE 1002A, WOODLAND HILLS, CA 91364-2633
(818) 914-5597
(818) 914-5596
Mailing address
20011 VENTURA BLVD STE 1002A, WOODLAND HILLS, CA 91364-2633
(818) 914-5597
(818) 914-5596
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
CLF 00349262
CA
Other
Enumeration date
11/07/2016
Last updated
11/07/2016
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