McCowan Clinical Laboratory, Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

MCCOWAN CLINICAL LABORATORY, INC

Doing business as

DH MCCOWAN MEDICAL LABORATORY

Practice address

178 W Commercial Ave
Coos Bay, OR 97420-1636

Phone

(541) 267-7853

Fax

(541) 267-4025

NPI assigned

Aug 30, 2006

Organization subpart

No

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

Authorized official

Name

Gayl Troyer

Title

Lab Manager

Phone

(541) 267-7853

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• DH MCCOWAN MEDICAL LABORATORY Doing business as

Medicare fee-for-service enrollment

Enrolled in OR

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

Locations

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490918400000",
    "number": "1851400071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "178 W COMMERCIAL AVE",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974201636",
            "telephone_number": "541-267-7853",
            "fax_number": "541-267-4025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "178 W COMMERCIAL AVE",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974201636",
            "telephone_number": "541-267-7853",
            "fax_number": "541-267-4025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCCOWAN CLINICAL LABORATORY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2017-03-31",
        "status": "A",
        "authorized_official_last_name": "TROYER",
        "authorized_official_first_name": "GAYL",
        "authorized_official_title_or_position": "LAB MANAGER",
        "authorized_official_telephone_number": "541-267-7853"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116103",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DH MCCOWAN MEDICAL LABORATORY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Fawn Mathis
• Angela Aracele Mayfield
• Thomas Francis McAndrew, MD
• Heidi Louise McCarthy, PTA
• Jane Lee McConnell, MSW
• Heather Dawn McDonald
• Cassandra Anne McDowell, DNP
• Sean McGarry
• Megan Jessica McGinnis, M.S., SLP-CCC
• Kimberly Ann McIlwain

• Clinical Medical Laboratory in Coos Bay, OR
• Providers in Coos Bay, OR by specialty
• Clinical Medical Laboratory in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2017; 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.