Provider Demographics
NPI:1952067027
Name:911COVIDTESTING INC
Entity Type:Organization
Organization Name:911COVIDTESTING INC
Other - Org Name:911 COVID TESTING, INC.
Other - Org Type:Other Name
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:FARZAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-569-5784
Mailing Address - Street 1:721 SANTA MONICA BLVD
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90401-2601
Mailing Address - Country:US
Mailing Address - Phone:888-878-9111
Mailing Address - Fax:
Practice Address - Street 1:721 SANTA MONICA BLVD
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90401-2601
Practice Address - Country:US
Practice Address - Phone:888-878-9111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-12
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory