Corgenix

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

CORGENIX

Practice address

11575 Main St Unit 400
Broomfield, CO 80020-2782

Phone

(303) 457-4345

NPI assigned

Feb 21, 2023

Organization subpart

No

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

Authorized official

Name

Mrs. Tammy Buckner

Title

Senior Director

Phone

(303) 457-4345

Specialties & licenses 1

Addresses

Other identifiers 2

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": "1676937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677024000000",
    "number": "1841998606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11575 MAIN ST UNIT 400",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800202782",
            "telephone_number": "303-457-4345",
            "fax_number": "303-457-4519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11575 MAIN ST UNIT 400",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800202782",
            "telephone_number": "303-457-4345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORGENIX",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-21",
        "last_updated": "2023-02-22",
        "certification_date": "2023-02-22",
        "status": "A",
        "authorized_official_last_name": "BUCKNER",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_title_or_position": "SENIOR DIRECTOR",
        "authorized_official_telephone_number": "303-457-4345",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA LICENSE",
            "identifier": "06D2146482",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAP",
            "identifier": "8323392",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Cari Cornish, PSY.D.
• Hollie Costello, LPC
• Kelli Ann Cotton, RN

• Clinical Medical Laboratory in Broomfield, CO
• Providers in Broomfield, 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 Feb 22, 2023; 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.