Individual provider · Type 1 NPI

Ketevan Gendzekhadze, PhD

Clinical Laboratory Director (Non-physician) · Duarte, CA

NPI number 1265700660 Active

Practice location

1500 Duarte Rd
Duarte, CA 91010-3012

Call (626) 256-8621 Map

Mailing address

1817 2nd St Apt 26
Duarte, CA 91010-1822

Specialties and licenses

TaxonomyCodeLicense
Clinical Laboratory Director (Non-physician) Primary 247ZC0005XDRK38 (CA)

Clinical Laboratory Director (Non-physician): An individual who is state-licensed as a clinical laboratory director and meets the qualifications in the Clinical Laboratory Improvement Amendments of 1988 for non-physicians (non-MD/DO) as defined in the CFR 42 Part 493.1405.

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About NPI 1265700660

Ketevan Gendzekhadze, PhD's National Provider Identifier is 1265700660, issued on Dec 13, 2011. The primary taxonomy on file is Clinical Laboratory Director (Non-physician) (247ZC0005X), and the practice location is in Duarte, CA. The record was last updated on Dec 13, 2011.