Provider Demographics
NPI:1700975844
Name:L AND S DIAGNOSTIC CENTER INC
Entity Type:Organization
Organization Name:L AND S DIAGNOSTIC CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ELEONORA
Authorized Official - Middle Name:
Authorized Official - Last Name:MAGHDASHYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-660-2409
Mailing Address - Street 1:1555 N VERMONT AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-5330
Mailing Address - Country:US
Mailing Address - Phone:323-660-2409
Mailing Address - Fax:323-912-0138
Practice Address - Street 1:5170 SANTA MONICA BLVD
Practice Address - Street 2:218
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90029-2428
Practice Address - Country:US
Practice Address - Phone:323-660-2409
Practice Address - Fax:323-912-0138
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
CATG 246Medicare ID - Type UnspecifiedIDTF