Organization Active NPI

Omega Diagnostic Inc

  • Clinical Medical Laboratory
  • Los Angeles, CA
National Provider Identifier
1710801220
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
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

Updated by the provider on Aug 31, 2026

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)CodeLicenseStatePrimary
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 Directory

Locations

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.

Verify at the official NPI Registry.