Immunology Diagnostics LLC
Clinical Medical Laboratory in Santa Monica, CA. Organization (NPI-2).
Details
- NPI
- 1134825219
- Entity type
- Organization (NPI-2)
- Legal business name
- Immunology Diagnostics LLC
- Organization subpart
- No
- Enumeration date
- Feb 1, 2023
- Certification date
- Apr 28, 2025
- Last updated
- Apr 28, 2025
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PART B SUPPLIER - INDEPENDENT CLINICAL LABORATORY
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 291U00000X | Clinical Medical Laboratory | – | – | Yes |
Practice location
1735 Stewart St Ste BSanta Monica, CA 90404-4021
Phone 310-444-1215 · Fax 310-861-9004
Mailing address
Po Box 10655Beverly Hills, CA 90213-3655
Phone 310-444-1215 · Fax 310-861-9004
Authorized official
Danny A Milner
Director
3104441215
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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