Cerritos Reference Laboratories Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

05D0955926 Issued in CA

Legal business name

CERRITOS REFERENCE LABORATORIES INC

Doing business as

Innovative Bioanalysis Laboratory

Practice address

3188 Airway Ave Ste D
Costa Mesa, CA 92626-4652

Phone

(504) 335-9660

NPI assigned

Aug 30, 2006

Organization subpart

No

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

Authorized official

Name

Haniya Khan

Title

Owner

Phone

(504) 335-9660

Specialties & licenses 1

Addresses

Other names 1

• Innovative Bioanalysis Laboratory Doing business as

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

Locations

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758499200000",
    "number": "1205946316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3188 AIRWAY AVE STE D",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926264652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3188 AIRWAY AVE STE D",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926264652",
            "telephone_number": "504-335-9660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CERRITOS REFERENCE LABORATORIES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2025-09-22",
        "certification_date": "2025-09-22",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "HANIYA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "504-335-9660"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "05D0955926",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Innovative Bioanalysis Laboratory",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Selene Aylene Cervantes-Avina
• Evelyn Jhoana Cervantes, MSW
• Gabriela Cervantes
• Savannah Cervantes
• Xochitl Karely Cervantes

• Clinical Medical Laboratory in Costa Mesa, CA
• Providers in Costa Mesa, 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 Sep 22, 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.