Active NPI
Omega Diagnostic Inc
- Clinical Medical Laboratory
- Los Angeles, CA
National Provider Identifier
1710801220
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- Legal business name
- OMEGA DIAGNOSTIC INC
- Practice address
- 5176 Santa Monica Blvd Ste 106
Los Angeles, CA 90029-2586 - Phone
- (213) 258-5965
- Fax
- (213) 258-5966
- NPI assigned
- Aug 6, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Rasambek Khatchiev
- Title
- Ceo,Cfo
- Phone
- (213) 258-5965
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | Primary |
Addresses
Primary practice location
5176 Santa Monica Blvd Ste 106
Los Angeles, CA 90029-2586
Mailing address
5176 Santa Monica Blvd Ste 106
Los Angeles, CA 90029-2586
Phone (213) 258-5965
National Provider Directory
National Provider DirectoryLocations
5176 Santa Monica Blvd
Ste 106
Los Angeles, CA 90029
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1785974400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1788134400000",
"number": "1710801220",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5176 SANTA MONICA BLVD STE 106",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900292586",
"telephone_number": "213-258-5965"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5176 SANTA MONICA BLVD STE 106",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900292586",
"telephone_number": "213-258-5965",
"fax_number": "213-258-5966"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "OMEGA DIAGNOSTIC INC",
"organizational_subpart": "NO",
"enumeration_date": "2026-08-06",
"last_updated": "2026-08-31",
"certification_date": "2026-08-31",
"status": "A",
"authorized_official_last_name": "KHATCHIEV",
"authorized_official_first_name": "RASAMBEK",
"authorized_official_title_or_position": "CEO,CFO",
"authorized_official_telephone_number": "213-258-5965"
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.