Provider Demographics
NPI:1255357000
Name:CARE AMERICA CLINICAL LAB INC
Entity type:Organization
Organization Name:CARE AMERICA CLINICAL LAB INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANOUSH
Authorized Official - Middle Name:
Authorized Official - Last Name:PAPAZIAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHLEBOTOMIST
Authorized Official - Phone:818-566-1626
Mailing Address - Street 1:3514 W VICTORY BLVD
Mailing Address - Street 2:STE B
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-1501
Mailing Address - Country:US
Mailing Address - Phone:818-566-1626
Mailing Address - Fax:818-841-1687
Practice Address - Street 1:3514 W VICTORY BLVD
Practice Address - Street 2:STE B
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-1501
Practice Address - Country:US
Practice Address - Phone:818-566-1626
Practice Address - Fax:818-841-1687
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACLF11737291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACLF11737OtherSTATE LICENSE