Bjo3 Labs Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

BJO3 LABS INC

Practice address

10545 Burbank Blvd Ste 121
North Hollywood, CA 91601-2246

Phone

(747) 336-0000

NPI assigned

Nov 4, 2024

Organization subpart

No

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

Authorized official

Name

Adrik Shawn Khodagholian

Title

Ceo

Phone

(747) 336-0000

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

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

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1730678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730678400000",
    "number": "1841013406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10545 BURBANK BLVD STE 121",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916012246",
            "telephone_number": "747-336-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10545 BURBANK BLVD STE 121",
            "city": "NORTH HOLLYWOOD",
            "state": "CA",
            "postal_code": "916012246",
            "telephone_number": "747-336-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BJO3 LABS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-04",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A",
        "authorized_official_last_name": "KHODAGHOLIAN",
        "authorized_official_first_name": "ADRIK",
        "authorized_official_middle_name": "SHAWN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "747-336-0000"
    },
    "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 North Hollywood, CA
• Providers in North Hollywood, 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 Nov 4, 2024; 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.