Crestline Labs Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

CRESTLINE LABS INC

Practice address

5000 Lankershim Blvd
112
Noho, CA 91601

Phone

(747) 363-9376

NPI assigned

Apr 9, 2026

Organization subpart

No

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

Authorized official

Name

Alla Safaryan

Title

Ceo

Phone

(747) 363-9376

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1775692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775692800000",
    "number": "1629911367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 LANKERSHIM BLVD",
            "address_2": "112",
            "city": "NOHO",
            "state": "CA",
            "postal_code": "91601",
            "telephone_number": "747-363-9376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 LANKERSHIM BLVD",
            "address_2": "112",
            "city": "NOHO",
            "state": "CA",
            "postal_code": "91601",
            "telephone_number": "747-363-9376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRESTLINE LABS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-09",
        "last_updated": "2026-04-09",
        "certification_date": "2026-04-09",
        "status": "A",
        "authorized_official_last_name": "SAFARYAN",
        "authorized_official_first_name": "ALLA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "747-363-9376"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suzette Galvez

• All providers in Noho, CA
• Clinical Medical Laboratory in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.