NPIMap

Organization Active NPI

Cobre Valley Regional Medical Center

Doing business as Cvrmc Lab

  • Clinical Medical Laboratory
  • Globe, AZ
National Provider Identifier
1003213828
Registry record updated Nov 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
H0126 Issued in AZ
Legal business name
COBRE VALLEY REGIONAL MEDICAL CENTER
Doing business as
Cvrmc Lab
Practice address
5880 S Hospital Dr
Globe, AZ 85501-9447
Phone
(928) 425-3261
Fax
(928) 425-3859
NPI assigned
Nov 21, 2014
Last updated
Nov 21, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
COBRE VALLEY REGIONAL MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 21, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Neal D Jensen
Title
Ceo
Phone
(928) 402-1122

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X H0126 AZ Primary

Addresses

Primary practice location

5880 S Hospital Dr
Globe, AZ 85501-9447

Mailing address

5880 S Hospital Dr
Globe, AZ 85501-9447
Phone (928) 425-3261

Other identifiers 1

IdentifierTypeStateIssuer
020644MedicaidAZ

Other names 1

  • CVRMC LAB Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
03D0641973Cobre Valley Regional Medical Center5880 S Hospital Dr, Globe, AZ 85501AccreditationJan 2, 2027
03D0882411Cobre Valley Regional Medical Center5880 South Hospital Drive, Globe, AZ 85501ComplianceMar 13, 2028

National Provider Directory

National Provider Directory
Tax ID family
Cobre Valley Comm Hospi14 organizations share this tax ID, including this one
Part of
Cobre Valley Comm Hospi

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1416528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416528000000",
    "number": "1003213828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5880 S HOSPITAL DR",
            "city": "GLOBE",
            "state": "AZ",
            "postal_code": "855019447",
            "telephone_number": "928-425-3261",
            "fax_number": "928-425-3859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5880 S HOSPITAL DR",
            "city": "GLOBE",
            "state": "AZ",
            "postal_code": "855019447",
            "telephone_number": "928-425-3261",
            "fax_number": "928-425-3859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COBRE VALLEY REGIONAL MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COBRE VALLEY REGIONAL MEDICAL CENTER",
        "enumeration_date": "2014-11-21",
        "last_updated": "2014-11-21",
        "status": "A",
        "authorized_official_last_name": "JENSEN",
        "authorized_official_first_name": "NEAL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "928-402-1122",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "AZ",
            "license": "H0126",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020644",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CVRMC LAB",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Globe, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.