Provider Demographics
NPI:1588713531
Name:CARE BIO CLINICAL CORP
Entity type:Organization
Organization Name:CARE BIO CLINICAL CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:WOLF
Authorized Official - Middle Name:
Authorized Official - Last Name:HOFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-534-5227
Mailing Address - Street 1:16311 VENTURA BLVD
Mailing Address - Street 2:SUITE 888
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-2124
Mailing Address - Country:US
Mailing Address - Phone:818-789-2585
Mailing Address - Fax:
Practice Address - Street 1:1631 VENTURA BLVD,
Practice Address - Street 2:SUITE 888
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436
Practice Address - Country:US
Practice Address - Phone:188-789-2585
Practice Address - Fax:929-252-9176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-09
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
31D2220104OtherCLIA
CALAB71670FMedicaid
CA05D0881670OtherCLIA