Provider Demographics
NPI:1447933312
Name:L&G LABORATORY INC
Entity type:Organization
Organization Name:L&G LABORATORY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TECHNICAL SUPERVISOR
Authorized Official - Prefix:DR
Authorized Official - First Name:AHSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BASEER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, CLS
Authorized Official - Phone:714-493-1224
Mailing Address - Street 1:14546 HAMLIN ST., UNIT 110
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91411
Mailing Address - Country:US
Mailing Address - Phone:818-479-3548
Mailing Address - Fax:818-450-0860
Practice Address - Street 1:14546 HAMLIN ST., UNIT 110
Practice Address - Street 2:
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91411
Practice Address - Country:US
Practice Address - Phone:818-479-3548
Practice Address - Fax:818-450-0860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-08
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACLF-90009918OtherSTATE LABORATORY LICENSE NUMBER