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Organization

LONGMONT CLINIC LAB

Active
Parent organization
LONGMONT CLINIC PC
Organization subpart
Yes

Provider details

NPI number
Legal business name
LONGMONT CLINIC PC
Authorized official
JACK CAMPBELL (ADMINISTRATOR)
(303) 776-1234
Entity
Organization

Contact information

Practice address
1925 MOUNTAIN VIEW AVE, LONGMONT, CO 80501-3128
(303) 776-1234
(720) 494-3107
Mailing address
1925 MOUNTAIN VIEW AVE, LONGMONT, CO 80501-3128
(303) 776-1234
(720) 494-3107

Taxonomy

Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
10251530000
CO

Other

Enumeration date
09/15/2006
Last updated
11/15/2007
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