Mediva LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

MEDIVA LLC

Practice address

5802 W Sample Ave
Fresno, CA 93722-3153

Phone

(929) 410-5754

NPI assigned

Oct 29, 2025

Organization subpart

No

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

Authorized official

Name

Mukesh Mukesh

Title

Owner

Phone

(929) 410-5754

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1761696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764633600000",
    "number": "1457229577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5802 W SAMPLE AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937223153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5802 W SAMPLE AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937223153",
            "telephone_number": "929-410-5754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDIVA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-10-29",
        "last_updated": "2025-12-02",
        "certification_date": "2025-12-02",
        "status": "A",
        "authorized_official_last_name": "MUKESH",
        "authorized_official_first_name": "MUKESH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "929-410-5754"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monique Renee Medina
• Rebecca Bibanco Medina
• Sabino Medina Jr.
• Sabino Orland Medina III, DPT
• Sandra Elaine Medina, MS
• Medline Medical Center
• Aubree Medlock
• Laurel J Medlock
• Medmark Treatment Center Fresno
• Medmark Treatment Centers - Fresno West, Inc.

• Clinical Medical Laboratory in Fresno, CA
• Providers in Fresno, 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 Dec 2, 2025; 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.