Individual
MR. LEVON SARDARYAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1301 N SAN FERNANDO BLVD, BURBANK, CA 91504-4236
(818) 557-0004
(818) 557-0040
Mailing address
1301 N SAN FERNANDO BLVD, BURBANK, CA 91504-4236
(818) 557-0004
(818) 557-0040
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
CLF00337819
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D1089622
CLIA
CA
01
—
BL898A
PTAN
CA
01
—
CLF00337819
STATE LICENSE
CA
01
—
DBA
DBA GENEX LABORATORY SERVICES
CA
Enumeration date
11/05/2008
Last updated
06/20/2018
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