Organization
DYNASTY DIAGNOSTICS
Active
Other names
DYNASTY DIAGNOSTICS
Organization subpart
No
Provider details
NPI number
Authorized official
AHSAN BASEER PHD., CLS (TECHNICAL SUPERVISOR)
(714) 493-1224
Entity
Organization
Contact information
Practice address
1718 COLORADO BLVD UNIT A, LOS ANGELES, CA 90041-1338
(747) 758-9797
Mailing address
1718 COLORADO BLVD UNIT A, LOS ANGELES, CA 90041-1338
(747) 758-9797
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D2326157
CLIA
CA
Enumeration date
08/19/2025
Last updated
08/19/2025
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