Medcorp Lab Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

MEDCORP LAB INC

Doing business as

MEDCORP LAB INC

Practice address

361 E Magnolia Blvd Rear Unitb
Burbank, CA 91502-3207

Phone

(818) 616-0898

Fax

(818) 619-0899

NPI assigned

Nov 11, 2024

Organization subpart

No

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

Authorized official

Name

Ahsan Baseer, PHD., CLS

Title

Technical Supervisor

Phone

(714) 493-1224

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• MEDCORP LAB INC Doing business as

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": "1731283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731283200000",
    "number": "1881418523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "361 E MAGNOLIA BLVD REAR UNITB",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915023207",
            "telephone_number": "818-616-0898",
            "fax_number": "818-619-0899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "361 E MAGNOLIA BLVD REAR UNITB",
            "city": "BURBANK",
            "state": "CA",
            "postal_code": "915023207",
            "telephone_number": "818-616-0898",
            "fax_number": "818-619-0899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDCORP LAB INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-11",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-10",
        "status": "A",
        "authorized_official_last_name": "BASEER",
        "authorized_official_first_name": "AHSAN",
        "authorized_official_title_or_position": "TECHNICAL SUPERVISOR",
        "authorized_official_telephone_number": "714-493-1224",
        "authorized_official_credential": "PHD., CLS"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA ID",
            "identifier": "05D2313528",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDCORP LAB INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Med RX Inc
• Med-Life Home Health, Inc.
• Medaid Home Health
• Medaid Transportation Inc.
• Medco Solutions, Inc.
• Lauren Medellin
• Medex Laboratory Inc
• Media City Hospice Care Inc
• Medical Pro Health Inc
• Medical Supply Market Inc

• Clinical Medical Laboratory in Burbank, CA
• Providers in Burbank, 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 11, 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.