Individual provider Active NPI

Levon Sardaryan

  • Clinical Medical Laboratory
  • Burbank, CA
National Provider Identifier
1790939643
Registry record updated Jun 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
CLF00337819 Issued in CA
Practice address
1301 N San Fernando Blvd
Burbank, CA 91504-4236
Phone
(818) 557-0004
Fax
(818) 557-0040
NPI assigned
Nov 5, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X CLF00337819 CA Primary

Addresses

Primary practice location

1301 N San Fernando Blvd
Burbank, CA 91504-4236

Mailing address

1301 N San Fernando Blvd
Burbank, CA 91504-4236
Phone (818) 557-0004

Other identifiers 4

IdentifierTypeStateIssuer
DBAOtherCADBA GENEX LABORATORY SERVICES
05D1089622OtherCACLIA
CLF00337819OtherCASTATE LICENSE
BL898AOtherCAPTAN

Other names 1

  • Dba Genex Laboratory Services Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CLF00337819CAMDClinical Medical Laboratory

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Hills Home Health Care, Inc Current Accepting new patients
Daylight Rcfe Inc Clinical Medical Laboratory PastSince Feb 26, 2023 Accepting new patients
Genex Laboratory Services,Inc Clinical Medical Laboratory Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1225843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529452800000",
    "number": "1790939643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 N SAN FERNANDO BLVD",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915044236",
            "telephone_number": "818-557-0004",
            "fax_number": "818-557-0040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 N SAN FERNANDO BLVD",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915044236",
            "telephone_number": "818-557-0004",
            "fax_number": "818-557-0040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARDARYAN",
        "first_name": "LEVON",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-11-05",
        "last_updated": "2018-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "CLF00337819",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DBA GENEX LABORATORY SERVICES",
            "identifier": "DBA",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "05D1089622",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "CLF00337819",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "BL898A",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DBA",
            "last_name": "LABORATORY SERVICES",
            "middle_name": "GENEX",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Burbank, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2018; 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.