Organization
BIO-TRANS LABORATORY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VALI KERMANI SR. PHD CCS ABMLI (PRESIDENT)
(818) 710-9545
Entity
Organization
Contact information
Practice address
23101 SHERMAN PLACE, STE 221, WEST HILLS, CA 91307
(818) 594-0573
(818) 710-9442
Mailing address
23101 SHERMAN PLACE, STE 221, WEST HILLS, CA 91307
(818) 594-0573
(818) 710-9442
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
CLF 11766
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D100767
CLIA #
CA
01
—
05D1007675
CLIA
—
01
—
222656952
BLUE SHIELD
—
01
—
CLF 11766
CA LAB LICENSE
CA
Enumeration date
12/05/2006
Last updated
07/16/2008
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