Organization Active NPI

City of Lubbock Health Department

  • Clinical Medical Laboratory
  • Lubbock, TX
National Provider Identifier
1689886319
Registry record updated May 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
CLIA 45D0660644 Issued in TX
Legal business name
CITY OF LUBBOCK HEALTH DEPARTMENT
Practice address
1902 Texas Ave
Lubbock, TX 79411
Phone
(806) 775-2906
Fax
(806) 775-3178
NPI assigned
May 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2010

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

Authorized official

Name
Dr. Cloyce Stetson, M.D.
Title
Medical Director
Phone
(806) 743-2463

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X CLIA 45D0660644 TX Primary

Addresses

Primary practice location

1902 Texas Ave
Lubbock, TX 79411

Mailing address

1902 Texas Ave
Lubbock, TX 79411
Phone (806) 775-2906

Other identifiers 1

IdentifierTypeStateIssuer
135103303MedicaidTX

National Provider Directory

National Provider Directory
Tax ID family
Health Dept of Lubbock3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

1902 Texas Ave
Lubbock, TX 79411
Phone (806) 775-2906

2015 50th St
Lubbock, TX 79412
Phone (806) 775-2933

1625 13th St
Lubbock, TX 79401

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274313600000",
    "number": "1689886319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1902 TEXAS AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "79411",
            "telephone_number": "806-775-2906",
            "fax_number": "806-775-3178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1902 TEXAS AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "79411",
            "telephone_number": "806-775-2906",
            "fax_number": "806-775-3178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF LUBBOCK HEALTH DEPARTMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2010-05-20",
        "status": "A",
        "authorized_official_last_name": "STETSON",
        "authorized_official_first_name": "CLOYCE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "806-743-2463",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "TX",
            "license": "CLIA 45D0660644",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "135103303",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.