Medi-Lab Corporation

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

MEDI-LAB CORPORATION

Practice address

424 W Broadway
Ste 110
Glendale, CA 91204-1209

Phone

(818) 502-9900

Fax

(866) 437-8784

NPI assigned

Oct 5, 2010

Last updated

Feb 21, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Khachatur Pogosyan

Title

Ceo

Phone

(818) 291-0547

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1286236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329782400000",
    "number": "1558670778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 250550",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912250550",
            "telephone_number": "818-502-9900",
            "fax_number": "866-437-8784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "424 W BROADWAY",
            "address_2": "STE 110",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912041209",
            "telephone_number": "818-502-9900",
            "fax_number": "866-437-8784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDI-LAB CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-05",
        "last_updated": "2012-02-21",
        "status": "A",
        "authorized_official_last_name": "POGOSYAN",
        "authorized_official_first_name": "KHACHATUR",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "818-291-0547",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Glendale, CA
• Providers in Glendale, 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 Feb 21, 2012; 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.