Provider Demographics
NPI:1154600575
Name:LABORATORY OF WEST
Entity type:Organization
Organization Name:LABORATORY OF WEST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ARMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:VOSKERCHYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-478-1947
Mailing Address - Street 1:800 S VICTORY BLVD
Mailing Address - Street 2:#107
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91502-2427
Mailing Address - Country:US
Mailing Address - Phone:818-478-1947
Mailing Address - Fax:818-478-1279
Practice Address - Street 1:800 S VICTORY BLVD
Practice Address - Street 2:#107
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91502-2427
Practice Address - Country:US
Practice Address - Phone:818-478-1947
Practice Address - Fax:818-478-1279
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-16
Last Update Date:2011-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPENDINGOtherWORK COMP