County of Weld Board of County Commissioners

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

06D0665967 Issued in CO

Legal business name

COUNTY OF WELD BOARD OF COUNTY COMMISSIONERS

Practice address

1555 N 17TH Ave
2ND Floor, Environmental Health
Greeley, CO 80631-9117

Phone

(970) 304-6410

NPI assigned

Jun 23, 2016

Organization subpart

No

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

Authorized official

Name

Mark E Wallace, M.D., M.P.H.

Title

Executive Director

Phone

(970) 304-6410

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Weld County Dept of Public Health & Environment Independent Lab Doing business as

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

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1466640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483574400000",
    "number": "1487005245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 N 17TH AVE",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806319117",
            "telephone_number": "970-304-6410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 N 17TH AVE",
            "address_2": "2ND FLOOR, ENVIRONMENTAL HEALTH",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806319117",
            "telephone_number": "970-304-6410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF WELD BOARD OF COUNTY COMMISSIONERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-23",
        "last_updated": "2017-01-05",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "970-304-6410",
        "authorized_official_credential": "M.D., M.P.H."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CO",
            "license": "06D0665967",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CMS CLIA",
            "identifier": "06D0665967",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "35628545",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Weld County Dept of Public Health & Environment Independent Lab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gerard John-Charles Coughlin, DPM RESIDENT
• Counseling Clinic LLC
• County of Weld
• County of Weld Board of County Commissioners
• County of Weld Board of County Commissioners
• County Road Counseling LLC
• Richard Lynn Coursey Jr., M.D.
• Buck Williams Covington II, MS, ACSM-CEP, CCES
• Emilee R Cowan
• Susan F Cowles, F.N.P.

• Clinical Medical Laboratory in Greeley, CO
• Providers in Greeley, CO by specialty
• Clinical Medical Laboratory in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2017; 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.