Organization Active NPI

Medivio LLC

  • Clinical Medical Laboratory
  • Richmond, TX
National Provider Identifier
1710817879
Registry record updated May 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
MEDIVIO LLC
Practice address
913 Crabb River Rd Ste B
Richmond, TX 77469-5889
Phone
(732) 762-0720
NPI assigned
May 20, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2026

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

Authorized official

Name
Abbas Muhammad Mujtaba
Title
Ceo
Phone
(323) 990-3502

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

913 Crabb River Rd Ste B
Richmond, TX 77469-5889

Mailing address

913 Crabb River Rd Ste B
Richmond, TX 77469-5889
Phone (732) 762-0720

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2344370Medivio LLC913 Crabb River Rd Unit B, Richmond, TX 77469Certificate of waiverMay 20, 2028

National Provider Directory

National Provider Directory
Tax ID family
Medivio LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1779235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779235200000",
    "number": "1710817879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "913 CRABB RIVER RD STE B",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774695889",
            "telephone_number": "732-762-0720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "913 CRABB RIVER RD STE B",
            "city": "RICHMOND",
            "state": "TX",
            "postal_code": "774695889",
            "telephone_number": "732-762-0720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDIVIO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-05-20",
        "last_updated": "2026-05-20",
        "certification_date": "2026-05-20",
        "status": "A",
        "authorized_official_last_name": "MUJTABA",
        "authorized_official_first_name": "ABBAS MUHAMMAD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "323-990-3502"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.