Provider Demographics
NPI:1316267164
Name:SPECTRUM ANALYSIS GROUP
Entity type:Organization
Organization Name:SPECTRUM ANALYSIS GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CARROLL
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:VELTMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-945-4376
Mailing Address - Street 1:2830 W 116TH PL APT 106
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80234-2521
Mailing Address - Country:US
Mailing Address - Phone:303-945-4376
Mailing Address - Fax:303-274-4598
Practice Address - Street 1:2830 W 116TH PL APT 106
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80234-2521
Practice Address - Country:US
Practice Address - Phone:303-945-4376
Practice Address - Fax:303-274-4598
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-03
Last Update Date:2011-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXCLAI45D 051736291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory