Avante Diagnostic Laboratory LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

AVANTE DIAGNOSTIC LABORATORY LLC

Doing business as

Avante Diagnostic Laboratory

Practice address

6704 Valjean Ave
Van Nuys, CA 91406-5818

Phone

(877) 883-8783

Fax

(818) 849-5442

NPI assigned

Nov 2, 2022

Organization subpart

No

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

Authorized official

Name

Sheila Busheri

Title

President / Ceo

Phone

(818) 324-3780

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Avante Diagnostic Laboratory Doing business as

Locations

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

{
    "created_epoch": "1667347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667347200000",
    "number": "1346957008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6704 VALJEAN AVE",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914065818",
            "telephone_number": "877-883-8783",
            "fax_number": "818-849-5442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6704 VALJEAN AVE",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914065818",
            "telephone_number": "877-883-8783",
            "fax_number": "818-849-5442"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVANTE DIAGNOSTIC LABORATORY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-02",
        "last_updated": "2022-11-02",
        "certification_date": "2022-11-02",
        "status": "A",
        "authorized_official_last_name": "BUSHERI",
        "authorized_official_first_name": "SHEILA",
        "authorized_official_title_or_position": "PRESIDENT / CEO",
        "authorized_official_telephone_number": "818-324-3780"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDPH",
            "identifier": "CDF-90005401",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "05D2244908",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avante Diagnostic Laboratory",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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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 2, 2022; 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.