Provider Demographics
NPI:1316200504
Name:AMERICAN SPECIALTY LABORATORY , INC
Entity type:Organization
Organization Name:AMERICAN SPECIALTY LABORATORY , INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATION
Authorized Official - Prefix:MS
Authorized Official - First Name:NAGHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ASKAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-280-5321
Mailing Address - Street 1:23679 CALABASAS RD
Mailing Address - Street 2:STE 601
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-1502
Mailing Address - Country:US
Mailing Address - Phone:818-280-5321
Mailing Address - Fax:
Practice Address - Street 1:20765 SUPERIOR ST
Practice Address - Street 2:
Practice Address - City:CHATSWORTH
Practice Address - State:CA
Practice Address - Zip Code:91311-4416
Practice Address - Country:US
Practice Address - Phone:818-280-5321
Practice Address - Fax:818-812-9173
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-21
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACLF00342719291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory