Moldx Labs Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

MOLDX LABS INC

Practice address

6450 Bellingham Ave Ste G
North Hollywood, CA 91606-1429

Phone

(820) 600-0006

NPI assigned

Mar 18, 2024

Organization subpart

No

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

Authorized official

Name

Vardan Tadevosyan

Title

Ceo

Phone

(820) 600-0006

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

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

{
    "created_epoch": "1710720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710806400000",
    "number": "1306605795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6450 BELLINGHAM AVE STE G",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916061429",
            "telephone_number": "820-600-0006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6450 BELLINGHAM AVE STE G",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916061429",
            "telephone_number": "820-600-0006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOLDX LABS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-18",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A",
        "authorized_official_last_name": "TADEVOSYAN",
        "authorized_official_first_name": "VARDAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "820-600-0006"
    },
    "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 Mar 19, 2024; 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.