Mogo Labs Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

MOGO LABS INC

Practice address

11631 Victory Blvd Ste 204
North Hollywood, CA 91606-3572

Phone

(747) 363-9504

NPI assigned

Nov 12, 2025

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Adrik Shawn Khodagholian

Title

Ceo

Phone

(747) 363-9504

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1762905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762905600000",
    "number": "1124988332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11631 VICTORY BLVD STE 204",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916063572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11631 VICTORY BLVD STE 204",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916063572",
            "telephone_number": "747-363-9504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOGO LABS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-12",
        "last_updated": "2025-11-12",
        "certification_date": "2025-11-12",
        "status": "A",
        "authorized_official_last_name": "KHODAGHOLIAN",
        "authorized_official_first_name": "ADRIK",
        "authorized_official_middle_name": "SHAWN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "747-363-9504"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in North Hollywood, CA
• Providers in North Hollywood, CA by specialty
• Clinical Medical Laboratory in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.