CMS-1500 Box 24J / 33a • NPI
1063180354
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
291U00000X (CMS 69)
CLIA-Certified Diagnostic Medical & Pathology Laboratory
Box 32 Service Location & ZIP+4
2212 LINCOLN AVE, ALTADENA, CA, 91001-5458
✓ 9-Digit EDI 837 ZIP+4 (91001-5458)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1063180354 (ALTA DIAGNOSTIC LABORATORIES, INC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Empirical CMS Medicare Claims, CPT Utilization & Part D Prescribing (NPI #1063180354)
Medicare Beneficiaries
981
Total Billed Services
30,066
Distinct CPT/HCPCS Codes
15
Medicare Allowed Total
$1,343,313.91
Actual Top Billed CPT / HCPCS Procedures (CMS Part B)
| CPT / HCPCS | Clinical Procedure Description | Services |
|---|---|---|
80307 | Testing for presence of drug, by chemistry analyzers | 641 |
86003 | Measurement of antibody (ige) to allergic substance, crude allergen extract, each | 22 |
86485 | Skin test for candida (yeast) | 71 |
87481 | Detection test for candida species (yeast), amplified probe technique | 4,956 |
87500 | Detection test by nucleic acid for vancomycin resistance strep (vre), amplified probe technique | 614 |
87635 | Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen | 542 |
87637 | Detection test by multiplex amplified probe technique for severe acute respiratory syndrome coronavirus 2 (sars-cov-2) (covid-19), influenza virus types a and b, and respiratory syncytial virus | 1,415 |
87640 | Detection test by nucleic acid for staphylococcus aureus (bacteria), amplified probe technique | 31 |
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1063180354 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | ALTA DIAGNOSTIC LABORATORIES, INC |
| Plain-English Specialty | CLIA-Certified Diagnostic Medical & Pathology Laboratory NUCC Code: 291U00000X (Clinical Medical Laboratory) |
| Certifying / Licensing Body | CMS CLIA / College of American Pathologists (CAP) |
| Practice Location Address | 2212 LINCOLN AVE, ALTADENA, CA, 91001-5458 |
| Practice Telephone / Fax | Tel: (626) 529-5181 | Fax: (626) 226-5964 |
| Administrative Mailing Address | 2212 LINCOLN AVE, ALTADENA, CA, 91001-5458 |
| Enumeration & Last Sync | Enumerated: 2021-09-01 | CMS Record Updated: 2024-12-13 |
| Authorized Official | MAYA CHAKHALYAN (Owner) |
Clinic Location, Accessibility & Directions
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Plain-English Taxonomy & CMS Crosswalk (291U00000X)
What Does Taxonomy Code 291U00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 291U00000X translates to:
"CLIA-Certified Diagnostic Medical & Pathology Laboratory"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (ALTA DIAGNOSTIC LABORATORIES, INC)
Typical CPT / Diagnostic Procedures:- Complete Blood Count (CBC) with Automated Differential (CPT 85025)
- Comprehensive Metabolic Panel (CMP), Fractionated Bilirubin & Hepatic Panel
- Quantitative Urine Culture & Colony Count (≥ 10⁵ CFU/mL) with Antibiotic Susceptibility
- HbA1c, Lipid Panel, TSH & High-Sensitivity Troponin Assays
- Diagnostic Reagent Panels & CLSI Antimicrobial Susceptibility Disks/MIC Cards
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
291U00000X — Clinical Medical LaboratoryPlain English: CLIA-Certified Diagnostic Medical & Pathology Laboratory | State: N/A | License: Verified | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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