Provider Demographics
NPI:1972747731
Name:PASADENA LABORATORY SERVICES INC
Entity type:Organization
Organization Name:PASADENA LABORATORY SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:K
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:720-207-1011
Mailing Address - Street 1:13547 VENTURA BLVD
Mailing Address - Street 2:SUITE 92
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91423-3825
Mailing Address - Country:US
Mailing Address - Phone:720-207-1011
Mailing Address - Fax:
Practice Address - Street 1:10800 E BETHANY DR
Practice Address - Street 2:SUITE 400
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-2687
Practice Address - Country:US
Practice Address - Phone:720-207-1011
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-23
Last Update Date:2009-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty