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06D0895949 CLIA NUMBER - JACKIE L MCCOLLUM, MD, PC

Laboratory Demographics

CLIA Number: 06D0895949

Facility Name: JACKIE L MCCOLLUM, MD, PC

Facility Address:
12101 E 2ND AVE, STE 105
AURORA, CO
ZIP 80011
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Facility Phone Number: 720 535-6204

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1063066256

Taxonomy: 171M00000X - Case Manager/Care Coordinator
A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee's progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management.

CLIA Record

Field Name Field Value
CLIA Number 06D0895949
LAB Type Physician Office
Facility Name JACKIE L MCCOLLUM, MD, PC
Street 12101 E 2ND AVE, STE 105
City AURORA
State CO
ZIP 80011
Phone 720 535-6204
CertificateType 4
CertificateEffectiveDate 12/21/2022
CertificateExpirationDate 12/20/2024
FacilityType Waiver

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This page was last updated on: 4/23/2024