Provider Demographics
NPI:1770670929
Name:ALLERGY TESTING LAB, INC.
Entity type:Organization
Organization Name:ALLERGY TESTING LAB, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:OGANESIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-953-2800
Mailing Address - Street 1:1510 W VERDUGO AVE
Mailing Address - Street 2:SUITE D
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91506-2472
Mailing Address - Country:US
Mailing Address - Phone:818-953-2800
Mailing Address - Fax:818-953-2828
Practice Address - Street 1:1510 W VERDUGO AVE
Practice Address - Street 2:SUITE D
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91506-2472
Practice Address - Country:US
Practice Address - Phone:818-953-2800
Practice Address - Fax:818-953-2828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACLF332751291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory