Provider Demographics
NPI:1861690620
Name:COMMUNITY LABS, INC.
Entity type:Organization
Organization Name:COMMUNITY LABS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:VAHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ADJIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-631-4025
Mailing Address - Street 1:3400 W VICTORY BLVD
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-1544
Mailing Address - Country:US
Mailing Address - Phone:818-843-3851
Mailing Address - Fax:818-843-3653
Practice Address - Street 1:3400 W VICTORY BLVD
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-1544
Practice Address - Country:US
Practice Address - Phone:818-843-3851
Practice Address - Fax:818-843-3653
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACLF11821291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACLF11821OtherCLIA