21st Century Diagnostic Laboratory, INC.
Clinical Medical Laboratory in Burbank, CA. Organization (NPI-2).
NPI number1407861990
StatusActive
Last updated in NPPESAug 3, 2022
Details
- NPI
- 1407861990
- Entity type
- Organization (NPI-2)
- Legal business name
- 21st Century Diagnostic Laboratory, INC.
- Organization subpart
- No
- Enumeration date
- Jul 31, 2006
- Certification date
- Aug 3, 2022
- Last updated
- Aug 3, 2022
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PART B SUPPLIER - INDEPENDENT CLINICAL LABORATORY
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 291U00000X | Clinical Medical Laboratory | 05D0956168 | CA | Yes |
Practice location
121 N Victory BlvdBurbank, CA 91502-1837
Phone 323-660-9480
Mailing address
121 N Victory BlvdBurbank, CA 91502-1837
Phone 323-660-9480
Authorized official
Hasmik Melkumyan
Sercretary
3236609480
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