Organization
MEDCORP LAB INC
Active
Other names
MEDCORP LAB INC
Organization subpart
No
Provider details
NPI number
Authorized official
AHSAN BASEER PHD., CLS (TECHNICAL SUPERVISOR)
(714) 493-1224
Entity
Organization
Contact information
Practice address
361 E MAGNOLIA BLVD REAR UNITB, BURBANK, CA 91502-3207
(818) 616-0898
(818) 619-0899
Mailing address
361 E MAGNOLIA BLVD REAR UNITB, BURBANK, CA 91502-3207
(818) 616-0898
(818) 619-0899
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D2313528
CLIA ID
CA
Enumeration date
11/11/2024
Last updated
11/11/2024
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