University of Southern California

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

05D0684670 Issued in CA

Legal business name

UNIVERSITY OF SOUTHERN CALIFORNIA

Doing business as

Usc Breast Cancer Analysis Laboratory

Practice address

1441 Eastlake Avenue
Room 5409
Los Angeles, CA 90033

Phone

(323) 865-0563

Fax

(323) 865-0122

NPI assigned

Mar 14, 2007

Last updated

Sep 18, 2015By the provider in NPPES

Organization subpart

Yes

Parent organization

UNIVERSITY OF SOUTHERN CALIFORNIAAs reported in NPPES

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

Authorized official

Name

Todd Dickey

Title

Sr VP - Administration

Phone

(213) 740-8184

Specialties & licenses 1

Addresses

Other identifiers 6

Other names 1

• USC BREAST CANCER ANALYSIS LABORATORY Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• University of Southern California

  dba Usc Endocrine Services Laboratory

  • Clinical Medical Laboratory
  • Pasadena, CA
  • NPI 1427181072

  O20050223000959

  Same enrollment
• University of Southern California

  dba Usc Electron Microscopy Laboratory

  • Clinical Medical Laboratory
  • Los Angeles, CA
  • NPI 1427181577

  O20050223000959

  Same enrollment
• University of Southern California

  dba Usc Immunohistochemistry Laboratory

  • Clinical Medical Laboratory
  • Los Angeles, CA
  • NPI 1467658849

  O20050223000959

  Same enrollment
• University of Southern California

  dba Usc Reproductive Endocrine Laboratory

  • Clinical Medical Laboratory
  • Los Angeles, CA
  • NPI 1881727220

  O20050223000959

  Same enrollment
• University of Southern California

  dba Usc Clinical Reference Laboratory

  • Clinical Medical Laboratory
  • Los Angeles, CA
  • NPI 1982738068

  O20050223000959

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Part of

Usc School of Dentistry

Locations

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442534400000",
    "number": "1568595684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 513199",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900511199",
            "telephone_number": "323-865-0563",
            "fax_number": "323-865-0122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 EASTLAKE AVENUE",
            "address_2": "ROOM 5409",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90033",
            "telephone_number": "323-865-0563",
            "fax_number": "323-865-0122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF SOUTHERN CALIFORNIA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNIVERSITY OF SOUTHERN CALIFORNIA",
        "enumeration_date": "2007-03-14",
        "last_updated": "2015-09-18",
        "status": "A",
        "authorized_official_last_name": "DICKEY",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "SR VP - ADMINISTRATION",
        "authorized_official_telephone_number": "213-740-8184"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "05D0684670",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE CODE",
            "identifier": "W7801B",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD CODE",
            "identifier": "ZZZ09704Z",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE",
            "identifier": "CLF315998",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "690000015",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LAB84670F",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID - UNSPECIFIED",
            "identifier": "05D0684670",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "USC BREAST CANCER ANALYSIS LABORATORY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• University of Southern California (Usc Electron Microscopy Laboratory)
• University of Southern California
• University of Southern California (Usc Immunohistochemistry Laboratory)
• University of Southern California (Herman Ostrow School of Dentistry Mobile Clinic)
• University of Southern California
• University of Southern California
• University of Southern California (Usc Medical Plaza Pharmacy)
• University of Southern California (USC Telebehavioral Health Clinic)
• University of Southern California (USC Norris Cancer Hospital)
• University of Southern California (USC School of Dentistry)

• Clinical Medical Laboratory in Los Angeles, CA
• Providers in Los Angeles, 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 18, 2015; 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.