Regents of the University of

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

05D0919331 Issued in CA

Legal business name

REGENTS OF THE UNIVERSITY OF

Doing business as

UCLA Outreach Clinical Lab-Panorama City

Practice address

14250 Arminta St
Panorama City, CA 91402-6871

Phone

(818) 989-6610

Fax

(818) 989-6775

NPI assigned

Jan 30, 2009

Organization subpart

Yes

Parent organization

THE REGENTS OF THE UNIVERSITY OF CALIFORNIAAs reported in NPPES

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

Authorized official

Name

Mr. Tammy Wallace

Title

Chief Financial Officer

Phone

(310) 794-8627

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• UCLA Outreach Clinical Lab-Panorama City Doing business as

Electronic endpoints 1

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

Part of

Regents of the University of California

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Regents Univ of Calif Los Angeles

  • Durable Medical Equipment & Medical Supplies
  • Los Angeles, CA
  • NPI 1356614291

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1233273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783555200000",
    "number": "1871731729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10920 WILSHIRE BLVD",
            "address_2": "STE 1600",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900246502",
            "telephone_number": "310-794-8299",
            "fax_number": "310-794-6790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14250 ARMINTA ST",
            "city": "PANORAMA CITY",
            "state": "CA",
            "postal_code": "914026871",
            "telephone_number": "818-989-6610",
            "fax_number": "818-989-6775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENTS OF THE UNIVERSITY OF",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "THE REGENTS OF THE UNIVERSITY OF CALIFORNIA",
        "enumeration_date": "2009-01-30",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "310-794-8627",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "05D0919331",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "05D0919331",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.3",
            "affiliationName": "Bluemark LLC / Office Ally",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "1300 SE Cardinal Ct Ste 190",
            "city": "Vancouver",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986839683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "UCLA Outreach Clinical Lab-Panorama City",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ashok Reddy, MD
• Suchitha M. Reddy, MD
• Vijayanti K. Reddy, MD
• Adam Rees
• Georgia Damilo Regalado, RN
• Rehabcare Unlimited Corporation
• Ana Isabel Reinis, LPT
• Marifi Remoquillo, DPT
• Reo Diagnostic Inc
• Juhtima Reuangsettakal

• Clinical Medical Laboratory in Panorama City, CA
• Providers in Panorama City, 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 Jul 9, 2026; 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.