Provider Demographics
NPI:1922459577
Name:FIRMALAB INC
Entity type:Organization
Organization Name:FIRMALAB INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:YADIRA
Authorized Official - Middle Name:
Authorized Official - Last Name:VALLES
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:818-789-1033
Mailing Address - Street 1:870 VINE ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90038-3724
Mailing Address - Country:US
Mailing Address - Phone:818-789-1033
Mailing Address - Fax:818-789-1061
Practice Address - Street 1:870 VINE ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90038-3724
Practice Address - Country:US
Practice Address - Phone:818-789-1033
Practice Address - Fax:818-789-1061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-24
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACLF 00328498291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory