Provider Demographics
NPI:1174637201
Name:NU ERA CLINICAL LABORATORIES
Entity Type:Organization
Organization Name:NU ERA CLINICAL LABORATORIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KAMO
Authorized Official - Middle Name:
Authorized Official - Last Name:MARGARYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-881-1565
Mailing Address - Street 1:18341 SHERMAN WAY
Mailing Address - Street 2:SUITE 201A
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-4472
Mailing Address - Country:US
Mailing Address - Phone:818-881-1565
Mailing Address - Fax:818-881-1959
Practice Address - Street 1:18341 SHERMAN WAY
Practice Address - Street 2:SUITE 201A
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-4472
Practice Address - Country:US
Practice Address - Phone:818-881-1565
Practice Address - Fax:818-881-1959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACLF333022291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory