CENTENNIAL STATE LAB, LLC (NPI# 1649829987) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649829987 |
| Entity Type | Organization |
| Organization Name | CENTENNIAL STATE LAB, LLC |
| Practice Address |
4775 Centennial Blvd Ste 120 Colorado Springs CO 80919-3309 |
| Mailing Address |
Po Box 15351 Springfield MA 01115-5351 |
| Practice Telephone | 7192843522 |
| Enumeration Date | 2019-09-10 |
| Last Update Date | 2020-01-09 |
| Authorized Official Name | STEPHANIE BROWN (OWNER) |
| Authorized Official Telephone | 7192843522 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | Laboratories |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | MEDICARE | 872314 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 950 Office Park Rd Ste 235, West Des Moines, IA 502652121 | 5154191742 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750990552 | Centennial State Lab, LLC | Clinical Medical Laboratory | 651 Corporate Cir Ste 104, Golden, CO 80401-5652 | 2020-07-28 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Centennial State Lab, LLC | 6245 W 53rd Ave, Arvada, CO 80002 |
| Street Address |
4775 CENTENNIAL BLVD STE 120 |
| City | COLORADO SPRINGS |
| State | CO |
| Zip Code | 80919-3309 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275171373 | Joshua Swanson | Chiropractor | 7075 Lexington Dr, Colorado Springs, CO 80919 | 2019-12-19 |
| 1144878000 | Perseverance Counseling, LLC | Counselor | 6645 Delmonico Drive, Suite 103, Colorado Springs, CO 80919 | 2019-09-03 |
| 1184288763 | Natasha Lei Michelle Meszler | Speech-Language Pathologist | 1130 W Woodmen Rd Ntsoc Inc, Colorado Springs, CO 80919 | 2019-04-29 |
| 1396207452 | Bruna Maria Vancleave | Physical Therapist | 1130 West Woodmen Road, Colorado Springs, CO 80919 | 2019-04-05 |
| 1346709425 | Brier Van Valin | Occupational Therapist | 1130 W. Woodmen Rd, Co Springs, CO 80919 | 2019-03-18 |
| 1285116756 | Amanda N Evanson | Behavioral Analyst | 2706 Fieldstone Road, Colorado Springs, CO 80919 | 2018-08-31 |
| 1033606124 | Kristina Reck | Dentist | 3340 W Woodmen Rd, Colorado Springs, CO 80919 | 2018-04-16 |
| 1326556192 | Charles Jacob Cox | Behavior Technician | 2760 Fieldstone Road, Colorado Springs, CO 80919 | 2018-01-16 |
| 1306360342 | Jessica Kledzinski | Specialist/Technologist | 5516 Big Paw Heights, Colorado Springs, CO 80919 | 2017-08-01 |
| 1790209732 | Maryanne Fitzgerald | Specialist/Technologist | 5625 Big Paw Heights, Colorado Springs, CO 80919 | 2017-08-01 |
| Find all providers in zip 80919 | ||||
| Taxonomy Code | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518519537 | Argo Inc | Clinical Medical Laboratory | 4720 Forge Rd Ste 108, Colorado Springs, CO 80907-3549 | 2019-07-10 |
| 1699246439 | Laboratory Corporation of America | Clinical Medical Laboratory | 2222 N Nevada Ave Ste 2025, Colorado Springs, CO 80907-6819 | 2018-12-05 |
| 1497279186 | Quest Diagnostics Clinical Laboratories Inc | Clinical Medical Laboratory | 1380 E Fillmore St Ste 110, Colorado Springs, CO 80907-6464 | 2017-08-03 |
| 1235671819 | Colorado Springs Pathology Associates PC | Clinical Medical Laboratory | 2838 Janitell Rd, E, Colorado Springs, CO 80906-4141 | 2016-11-14 |
| 1811248735 | Apsp-colorado Springs, LLC | Clinical Medical Laboratory | 1625 Medical Center Pt. #260, Colorado Springs, CO 80907 | 2012-10-02 |
| 1316110588 | Clifford Consulting and Research Inc | Clinical Medical Laboratory | 4775 Centennial Blvd Ste 112, Colorado Springs, CO 80919-3309 | 2008-04-09 |
| 1609344290 | Apex Physical Medicine and Rehabilitation Professional LLC | Clinical Medical Laboratory | 3910 S Carefree Cir Ste F, Colorado Springs, CO 80917-3053 | 2018-11-13 |
| 1518453273 | Sandstone Care Cos, LLC | Clinical Medical Laboratory | 2102 University Park Blvd, Colorado Springs, CO 80918-3678 | 2018-07-06 |
| 1760906499 | Quest Diagnostics Clinical Laboratories Inc | Clinical Medical Laboratory | 2141 Academy Cir, Colorado Springs, CO 80909-1686 | 2017-08-03 |
| 1528581394 | Blue Crown Laboratories | Clinical Medical Laboratory | 4820 Rusina Rd Ste C, Colorado Springs, CO 80907-8127 | 2017-07-24 |
| Find all providers in COLORADO SPRINGS | ||||
| City | COLORADO SPRINGS |
| Zip Code | 80919 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.