Blue Nile Clinic Lab

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

BLUE NILE CLINIC LAB

Doing business as

PCL Lab

Practice address

11275 E Mississippi Ave Ste 2W1
Aurora, CO 80012-2828

Phone

(720) 573-3823

Fax

(720) 639-9037

NPI assigned

Sep 25, 2024

Last updated

Sep 26, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Abigail Mengesha

Title

Owner

Phone

(720) 288-7337

Specialties & licenses 1

Addresses

Other names 1

• PCL Lab Doing business as

Medicare fee-for-service enrollment

Enrolled in CO

Enrollment records 1

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

CLIA laboratory certificates

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

{
    "created_epoch": "1727222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727308800000",
    "number": "1700603115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11275 E MISSISSIPPI AVE STE 2W1",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800122828",
            "telephone_number": "720-573-3823",
            "fax_number": "720-639-9037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11275 E MISSISSIPPI AVE STE 2W1",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800122828",
            "telephone_number": "720-573-3823",
            "fax_number": "720-639-9037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE NILE CLINIC LAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-25",
        "last_updated": "2024-09-26",
        "certification_date": "2024-09-26",
        "status": "A",
        "authorized_official_last_name": "MENGESHA",
        "authorized_official_first_name": "ABIGAIL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "720-288-7337"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PCL Lab",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PCL Lab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kaitlin Blotske, PHARMD
• Kathryn Bloxsom, RD
• Blue Channel Therapy
• Blue Mesa Dental Assoc PC
• Blue Nile Clinic
• Blue Nile Primary Care, LLC
• Blue Sprig Pediatrics
• Blue Wings Home Care LLC
• Allison Bluhm, RN
• Rachel Blum

• Clinical Medical Laboratory in Aurora, CO
• Providers in Aurora, 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 Sep 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.