NPIMap

Organization Active NPI

Saint Benedict Medical Group Clinical Laboratory

  • Clinical Medical Laboratory
  • Lennox, CA
National Provider Identifier
1326211301
Registry record updated Apr 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
291U00000X Issued in CA
Legal business name
SAINT BENEDICT MEDICAL GROUP CLINICAL LABORATORY
Practice address
11117 S Inglewood Ave
Lennox, CA 90304-2514
Phone
(310) 256-6586
Fax
(310) 672-5900
NPI assigned
Apr 10, 2008
Organization subpart
Yes
Parent organization
SAINT BENEDICT MEDICAL GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 10, 2008

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

Authorized official

Name
Jacob Edem
Title
Administrator
Phone
(213) 479-5324

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 291U00000X CA Primary

Addresses

Primary practice location

11117 S Inglewood Ave
Lennox, CA 90304-2514

Mailing address

11117 S Inglewood Ave
Lennox, CA 90304-2514
Phone (310) 256-6586

National Provider Directory

National Provider Directory
Part of
Saint Benedict Med GRP Inc

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1207785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207785600000",
    "number": "1326211301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11117 S INGLEWOOD AVE",
            "city": "LENNOX",
            "state": "CA",
            "postal_code": "903042514",
            "telephone_number": "310-256-6586",
            "fax_number": "310-672-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11117 S INGLEWOOD AVE",
            "city": "LENNOX",
            "state": "CA",
            "postal_code": "903042514",
            "telephone_number": "310-256-6586",
            "fax_number": "310-672-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT BENEDICT MEDICAL GROUP CLINICAL LABORATORY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SAINT BENEDICT MEDICAL GROUP",
        "enumeration_date": "2008-04-10",
        "last_updated": "2008-04-10",
        "status": "A",
        "authorized_official_last_name": "EDEM",
        "authorized_official_first_name": "JACOB",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "213-479-5324"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "291U00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lennox, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.