1609388842 NPI number — CLARO SCIENTIFIC LABORATORIES CORP

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609388842 NPI number — CLARO SCIENTIFIC LABORATORIES CORP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CLARO SCIENTIFIC LABORATORIES CORP
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
CLAROLABS
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1609388842
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/17/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1408 HORIZON AVE STE 101
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAFAYETTE
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80026-8500
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
720-749-2815
Provider Business Mailing Address Fax Number:
720-925-5708

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1408 HORIZON AVE STE 101
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAFAYETTE
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80026
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
720-749-2815
Provider Business Practice Location Address Fax Number:
720-925-5708
Provider Enumeration Date:
10/27/2017

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
LOS
Authorized Official First Name:
LAYNE
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
720-749-2815

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)