Provider Demographics
NPI:1821744681
Name:HARVEST IVF LABORATORY LLC
Entity type:Organization
Organization Name:HARVEST IVF LABORATORY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-538-4838
Mailing Address - Street 1:125 W HUNTINGTON DR. BLDG B 3RD FLOOR
Mailing Address - Street 2:
Mailing Address - City:ARCAOIA
Mailing Address - State:CA
Mailing Address - Zip Code:91007
Mailing Address - Country:US
Mailing Address - Phone:626-538-4838
Mailing Address - Fax:626-254-8821
Practice Address - Street 1:125 W HUNTINGTON DR BLDG B3
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-3050
Practice Address - Country:US
Practice Address - Phone:626-538-4838
Practice Address - Fax:626-254-8821
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-01
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory