NPIMap

Organization Active NPI

County of Humboldt

  • Clinical Medical Laboratory
  • Eureka, CA
National Provider Identifier
1689751687
Registry record updated Jan 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
05D0666113 Issued in CA
Legal business name
COUNTY OF HUMBOLDT
Practice address
529 I Street
Eureka, CA 95501-1116
Phone
(707) 445-6200
Fax
(707) 445-6097
NPI assigned
Nov 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2010

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

Authorized official

Name
Susan Buckley
Title
Public Health Branch Director
Phone
(707) 268-2121

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 05D0666113 CA Primary

Addresses

Primary practice location

529 I Street
Eureka, CA 95501-1116

Mailing address

529 I Street
Eureka, CA 95501-1116
Phone (707) 445-6200

Other identifiers 1

IdentifierTypeStateIssuer
LAB58595FMedicaidCA

Other names 1

  • Dept of Health & Human Services Public Health Branch Laboratory Other name

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners 66

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 66

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
05D0666113Humboldt County Public Health Laboratory529 I St, Eureka, CA 95501ComplianceFeb 20, 2027

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262649600000",
    "number": "1689751687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "529 I STREET",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955011116",
            "telephone_number": "707-445-6200",
            "fax_number": "707-445-6097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "529 I STREET",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955011116",
            "telephone_number": "707-445-6200",
            "fax_number": "707-445-6097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF HUMBOLDT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2010-01-05",
        "status": "A",
        "authorized_official_last_name": "BUCKLEY",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "PUBLIC HEALTH BRANCH DIRECTOR",
        "authorized_official_telephone_number": "707-268-2121"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "05D0666113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LAB58595F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dept of Health & Human Services Public Health Branch Laboratory",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Eureka, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2010; 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.