Provider Demographics
NPI:1952437741
Name:COLORADO DIAGNOSTIC CENTER INC
Entity Type:Organization
Organization Name:COLORADO DIAGNOSTIC CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARINA
Authorized Official - Middle Name:
Authorized Official - Last Name:SEGAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-751-8300
Mailing Address - Street 1:10200 E GIRARD AVE STE C350
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-5514
Mailing Address - Country:US
Mailing Address - Phone:303-751-8300
Mailing Address - Fax:
Practice Address - Street 1:10200 E GIRARD AVE STE C350
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231-5514
Practice Address - Country:US
Practice Address - Phone:303-751-8300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory