Centennial State Lab, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

CENTENNIAL STATE LAB, LLC

Practice address

651 Corporate Cir Ste 104
Golden, CO 80401-5652

Phone

(303) 800-2595

Fax

(303) 800-2596

NPI assigned

Jul 28, 2020

Last updated

Jul 28, 2020By 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

Stephanie L Brown

Title

Director of Operations

Phone

(719) 284-3522

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1595894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595894400000",
    "number": "1750990552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "651 CORPORATE CIR STE 104",
            "city": "GOLDEN",
            "state": "CO",
            "postal_code": "804015652",
            "telephone_number": "303-800-2595",
            "fax_number": "303-800-2596"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 CORPORATE CIR STE 104",
            "city": "GOLDEN",
            "state": "CO",
            "postal_code": "804015652",
            "telephone_number": "303-800-2595",
            "fax_number": "303-800-2596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTENNIAL STATE LAB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-28",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "719-284-3522"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Orion A Castro, LCSW
• Michael A. Catalano, M.D.
• Catholic Health Initiatives Colorado (Centura Health Emergency and Urgent Care - Golden)
• Catholic Health Initiatives Colorado (Urgent Care of Golden)
• Catholic Health Initiatives Colorado (GDNH Primary Care)
• Center for Cosmetic Surgery PC
• Cory William Center
• Cerviom LLC
• Mary M. Ceynowa, LPC, LP
• Chad Hartley MD Pllcc

• Clinical Medical Laboratory in Golden, CO
• Providers in Golden, 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 Jul 28, 2020; 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.