Latara Enterprise Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

CLF 489 Issued in CA

Legal business name

LATARA ENTERPRISE INC.

Doing business as

Foundation Laboratory

Practice address

1716 W Holt Ave
Pomona, CA 91768-3333

Phone

(909) 623-9301

Fax

(909) 623-9306

NPI assigned

Jul 7, 2006

Last updated

Dec 17, 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

Lala Vartanian

Title

Secretary

Phone

(909) 623-9301

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Foundation Laboratory Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355702400000",
    "number": "1881626943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1716 W HOLT AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917683333",
            "telephone_number": "909-623-9301",
            "fax_number": "909-623-9306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1716 W HOLT AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917683333",
            "telephone_number": "909-623-9301",
            "fax_number": "909-623-9306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LATARA ENTERPRISE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2012-12-17",
        "status": "A",
        "authorized_official_last_name": "VARTANIAN",
        "authorized_official_first_name": "LALA",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "909-623-9301"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "CLF 489",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA NUMBER",
            "identifier": "05D0642889",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "X058428",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LAB42889F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Foundation Laboratory",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jade Larkins
• Hayleigh Larson
• Jessica Lynn Larson
• Marie C Lassaigne
• Alex Lassard, PHARMD
• Cassidy Latham
• Alaa Latif, MD
• Alexa Nichole Lattman
• Michael Robert Laturner, AGACNP-BC
• Candice Lau

• Clinical Medical Laboratory in Pomona, CA
• Providers in Pomona, 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 Dec 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.