Provider Demographics
NPI:1437571577
Name:RAD UNIVERSAL INC
Entity Type:Organization
Organization Name:RAD UNIVERSAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ARSEN
Authorized Official - Middle Name:
Authorized Official - Last Name:AVEDISYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-670-8990
Mailing Address - Street 1:12826 VICTORY BLVD
Mailing Address - Street 2:STE D
Mailing Address - City:NORTH HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:91606-3013
Mailing Address - Country:US
Mailing Address - Phone:818-670-8990
Mailing Address - Fax:
Practice Address - Street 1:12826 VICTORY BLVD
Practice Address - Street 2:STE D
Practice Address - City:NORTH HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:91606-3013
Practice Address - Country:US
Practice Address - Phone:818-670-8990
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-08
Last Update Date:2014-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory