Consolab Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

05D1090253 Issued in CA

Legal business name

CONSOLAB INC

Practice address

6333 Woodman Ave
Suite K
Van Nuys, CA 91401-2361

Phone

(818) 742-8716

NPI assigned

Nov 3, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Igor Efimenko

Title

President

Phone

(818) 742-8716

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1225670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225670400000",
    "number": "1306099346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6333 WOODMAN AVE",
            "address_2": "SUITE K",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914012361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6333 WOODMAN AVE",
            "address_2": "SUITE K",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914012361",
            "telephone_number": "818-742-8716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONSOLAB INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-03",
        "last_updated": "2008-11-03",
        "status": "A",
        "authorized_official_last_name": "EFIMENKO",
        "authorized_official_first_name": "IGOR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "818-742-8716"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "05D1090253",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Van Nuys, CA
• Providers in Van Nuys, CA by specialty
• Clinical Medical Laboratory in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.