One Lab LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

ONE LAB LLC

Practice address

211 N Prairie Ave
Suite H
Inglewood, CA 90301-1412

Phone

(310) 740-1279

NPI assigned

Apr 27, 2016

Organization subpart

No

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

Authorized official

Name

Bruck Mengistu

Title

Officer

Phone

(310) 740-1279

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

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

{
    "created_epoch": "1461715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461715200000",
    "number": "1831544725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 N PRAIRIE AVE",
            "address_2": "SUITE H",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903011412",
            "telephone_number": "310-740-1279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 N PRAIRIE AVE",
            "address_2": "SUITE H",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903011412",
            "telephone_number": "310-740-1279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ONE LAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-27",
        "last_updated": "2016-04-27",
        "status": "A",
        "authorized_official_last_name": "MENGISTU",
        "authorized_official_first_name": "BRUCK",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "310-740-1279"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Medical Laboratory in Inglewood, CA
• Providers in Inglewood, 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 Apr 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.