Provider Demographics
NPI:1033003017
Name:BIOMEDEX DIAGNOSTIC LABORATORY INC.
Entity type:Organization
Organization Name:BIOMEDEX DIAGNOSTIC LABORATORY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:FATIMAH
Authorized Official - Middle Name:
Authorized Official - Last Name:OGUNMOWO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-322-5686
Mailing Address - Street 1:16250 VENTURA BLVD STE 165
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-2273
Mailing Address - Country:US
Mailing Address - Phone:747-264-1780
Mailing Address - Fax:
Practice Address - Street 1:16250 VENTURA BLVD STE 165
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2273
Practice Address - Country:US
Practice Address - Phone:747-264-1780
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-05
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory