Organization Active NPI

Second Bio Lab Clinical Laboratory LLC

  • Nurse Practitioner
  • San Gabriel, CA
National Provider Identifier
1285590687
Registry record updated Dec 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
SECOND BIO LAB CLINICAL LABORATORY LLC
Practice address
316 E Las Tunas Dr Ste 206
San Gabriel, CA 91776-1535
Phone
(323) 220-3976
NPI assigned
Dec 29, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2025

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

Authorized official

Name
Yelnur Sariyev
Title
Practice Owner
Phone
(323) 220-3976

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

316 E Las Tunas Dr Ste 206
San Gabriel, CA 91776-1535

Mailing address

316 E Las Tunas Dr Ste 206
San Gabriel, CA 91776-1535
Phone (323) 220-3976

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260311000168 CA Part B Supplier - Independent Clinical Laboratory 4183107949 Practice locations: San Gabriel, CA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1766966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766966400000",
    "number": "1285590687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 E LAS TUNAS DR STE 206",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917761535",
            "telephone_number": "323-220-3976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 E LAS TUNAS DR STE 206",
            "city": "SAN GABRIEL",
            "state": "CA",
            "postal_code": "917761535",
            "telephone_number": "323-220-3976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SECOND BIO LAB CLINICAL LABORATORY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-29",
        "last_updated": "2025-12-29",
        "certification_date": "2025-12-29",
        "status": "A",
        "authorized_official_last_name": "SARIYEV",
        "authorized_official_first_name": "YELNUR",
        "authorized_official_title_or_position": "PRACTICE OWNER",
        "authorized_official_telephone_number": "323-220-3976"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Gabriel, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.