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SUPERCLINIC PROFESSIONALS MEDICAL CORP A CALIFORNIA CORPORATION
NPI 1326564212
Clinic/Center - Multi-Specialty in North Hollywood, CA

Active since August 22, 2017CLIA 05D1057982 · Waiver
12134 VICTORY BLVD, NORTH HOLLYWOOD, CA 91606(818) 762-8702(818) 761-2583 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 21, 2022, Aug 22, 2017 (2 updates tracked since 2017).

About Superclinic Professionals Medical Corp A California Corporation NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SUPERCLINIC PROFESSIONALS MEDICAL CORP A CALIFORNIA CORPORATION (NPI 1326564212) is a healthcare organization registered as a multi-specialty in North Hollywood, California and active in the NPI registry since August 2017. The organization holds a CLIA Waiver certificate valid through August 24, 2026 and lists Mitchell Paul Rubin, Administrator, as its authorized official.

NPPES Registry Identity

NPI1326564212
Entity TypeOrganization
Primary Taxonomy261QM1300X
Legal Business NameSUPERCLINIC PROFESSIONALS MEDICAL CORP A CALIFORNIA CORPORATION
Location Address12134 VICTORY BLVDNorth Hollywood, CA 91606-3205
Mailing Address12134 Victory BlvdNorth Hollywood, CA 91606-3205 · (818) 762-8702 · Fax (818) 761-2583
Phone(818) 762-8702
Fax(818) 761-2583
Organization SubpartNo
Authorized OfficialMitchell Paul RubinAdministrator · (818) 762-8702
Enumeration DateAugust 22, 2017
Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration
✔ NPI 1326564212 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM1300X
12134 VICTORY BLVD, North Hollywood, CA 91606
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D1057982

Superclinic Professionals Medical Corporation · North Hollywood, CA
Active · expires Aug 24, 2026
CLIA Number05D1057982
Laboratory TypePhysician Office
Certificate Effective DateAugust 25, 2024
Certificate Expiration DateAugust 24, 2026
Laboratory DirectorArchie Mays
Laboratory Phone(818) 762-8702
Laboratory LocationSuperclinic Professionals Medical Corporation12134 Victory Blvd Ste C, North Hollywood, CA 91606
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CLOVER MEDICAL CORPORATION INC
Family Medicine
12134 VICTORY BLVD, SUITE C
NORTH HOLLYWOOD, CA 91606
Los Angeles County (818) 762-8702
EDWARD RUBIN MD
Family Medicine
12134 VICTORY BLVD
NORTH HOLLYWOOD, CA 91606
Los Angeles County (818) 749-7499
CLOVER SURGICAL CENTER, INC., A CALIFORNIA CORPORATION
Clinic/Center (Ambulatory Surgical)
12134 VICTORY BLVD, SUITE E
NORTH HOLLYWOOD, CA 91606
Los Angeles County (818) 762-8702
ISLA SURGERY CENTER, INC., A CALIFORNIA CORPORATION
Clinic/Center (Ambulatory Surgical)
12134 VICTORY BLVD, SUITE E
NORTH HOLLYWOOD, CA 91606
Los Angeles County (818) 762-8702
MR. LUIS A TROMPETA PA-C
Physician Assistant (Medical)
12134 VICTORY BLVD
NORTH HOLLYWOOD, CA 91606
Los Angeles County (818) 762-8702

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Superclinic Professionals Medical Corp A California Corporation's NPI number?

The NPI number for Superclinic Professionals Medical Corp A California Corporation is 1326564212. It was assigned to this organization in the NPPES registry on August 22, 2017.

Where is Superclinic Professionals Medical Corp A California Corporation located?

Superclinic Professionals Medical Corp A California Corporation is located at 12134 Victory Blvd, North Hollywood, CA 91606. The listed phone number is (818) 762-8702.

What is Superclinic Professionals Medical Corp A California Corporation's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

Does Superclinic Professionals Medical Corp A California Corporation hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D1057982) is associated with this NPI, valid through August 24, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Superclinic Professionals Medical Corp A California Corporation was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.