Provider Demographics
NPI:1932345972
Name:CAMBRIDGE LABS INC
Entity Type:Organization
Organization Name:CAMBRIDGE LABS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:NORAYR
Authorized Official - Middle Name:
Authorized Official - Last Name:VARDANYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-344-1346
Mailing Address - Street 1:7035 RESEDA
Mailing Address - Street 2:STE A
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-4209
Mailing Address - Country:US
Mailing Address - Phone:818-344-1346
Mailing Address - Fax:818-344-1355
Practice Address - Street 1:7035 RESEDA
Practice Address - Street 2:STE A
Practice Address - City:RESEDA
Practice Address - State:CA
Practice Address - Zip Code:91335-4209
Practice Address - Country:US
Practice Address - Phone:818-344-1346
Practice Address - Fax:818-344-1355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-22
Last Update Date:2010-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA3034101291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA05D1086661Medicare PIN