Provider Demographics
NPI:1134369457
Name:REGENTS OF THE UNIVERSITY OF COLORADO
Entity type:Organization
Organization Name:REGENTS OF THE UNIVERSITY OF COLORADO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FREED
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:303-724-0535
Mailing Address - Street 1:12705 E MONTVIEW BLVD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80045-7108
Mailing Address - Country:US
Mailing Address - Phone:303-724-0535
Mailing Address - Fax:303-724-1310
Practice Address - Street 1:12705 E MONTVIEW BLVD
Practice Address - Street 2:SUITE 250
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-7108
Practice Address - Country:US
Practice Address - Phone:303-724-0535
Practice Address - Fax:303-724-1310
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REGENTS OF THE UNIVERSITY OF COLORADO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-02-26
Last Update Date:2015-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory