Organization
MEDCORP LAB INC
Active
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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