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SOUTHERN COLORADO CLINIC PC
NPI 1285613554
Clinic/Center in Pueblo, CO

Active since January 13, 2006CLIA Certified · 2 labs
3676 PARKER BLVD, PUEBLO, CO 81008(719) 553-2200(719) 553-2213 Get Directions Write a Review

NPPES record last updated: December 5, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Southern Colorado Clinic Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHERN COLORADO CLINIC PC (NPI 1285613554) is a healthcare organization registered as a clinic/center in Pueblo, Colorado and active in the NPI registry since January 2006. The organization holds 2 active CLIA laboratory certificates and lists Jennifer Arellano, Coo, as its authorized official.

NPPES Registry Identity

NPI1285613554
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameSOUTHERN COLORADO CLINIC PC
Location Address3676 PARKER BLVDPueblo, CO 81008-2212
Mailing AddressPo Box 9000Pueblo, CO 81008-9000 · (719) 553-2200 · Fax (719) 553-2216
Phone(719) 553-2200
Fax(719) 553-2213
Organization SubpartNo
Authorized OfficialJennifer ArellanoCoo · (719) 553-1801
Enumeration DateJanuary 13, 2006
Last NPPES UpdateDecember 5, 2022
NPPES CertifiedDecember 5, 2022
✔ NPI 1285613554 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
3676 PARKER BLVD, Pueblo, CO 81008
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CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 06D2221226

Southern Colorado Clinic, PC · Pueblo, CO
Active · expires Apr 19, 2027
CLIA Number06D2221226
Laboratory TypePhysician Office
Certificate Effective DateApril 20, 2025
Certificate Expiration DateApril 19, 2027
Laboratory DirectorDr. Patrick K. Timms
Laboratory Phone(719) 553-2200
Laboratory LocationSouthern Colorado Clinic, PC4112 Outlook Blvd, Suite 290, Pueblo, CO 81008
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 06D2194271

Southern Colorado Clinic, PC · Pueblo West, CO
Active · expires Nov 10, 2026
CLIA Number06D2194271
Laboratory TypePhysician Office
Certificate Effective DateNovember 11, 2024
Certificate Expiration DateNovember 10, 2026
Laboratory DirectorDr. Scott A. Deruiter
Laboratory Phone(719) 553-2200
Laboratory LocationSouthern Colorado Clinic, PC109 S Burlington Drive, Pueblo West, CO 81007
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. RITA ANN ELLSWORTH MD
Pediatrics
3676 PARKER BLVD
PUEBLO, CO 81008
Pueblo County (719) 553-2200
MS. MARSHA R FLOWERS OTC
3676 PARKER BLVD
PUEBLO, CO 81008
Pueblo County (719) 553-2206
HAVILAH R. SPURLOCK FNP-C
Nurse Practitioner (Family)
3676 PARKER BLVD
PUEBLO, CO 81008
Pueblo County (719) 553-2200
JENNIFER LIVINGSTON
Nurse Practitioner (Family)
3676 PARKER BLVD
PUEBLO, CO 81008
Pueblo County (719) 553-2200
DR. QUEENTER KISANG MD
Family Medicine
3676 PARKER BLVD
PUEBLO, CO 81008
Pueblo County (719) 553-1804
MISS CARLA RAE PROCTOR M.D.
Pediatrics
3676 PARKER BLVD
PUEBLO, CO 81008
Pueblo County (719) 553-2204
MR. RYAN SCOTT ESLINGER OTC
3676 PARKER BLVD
PUEBLO, CO 81008
Pueblo County (719) 553-2200
UROLOGY OF SOUTHERN COLORADO PLLC
Clinic/Center (Medical Specialty)
3676 PARKER BLVD, SUITE 310
PUEBLO, CO 81008
Pueblo County (719) 545-1500

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southern Colorado Clinic PC's NPI number?

The NPI number for Southern Colorado Clinic PC is 1285613554. It was assigned to this organization in the NPPES registry on January 13, 2006.

Where is Southern Colorado Clinic PC located?

Southern Colorado Clinic PC is located at 3676 Parker Blvd, Pueblo, CO 81008. The listed phone number is (719) 553-2200.

What is Southern Colorado Clinic PC's specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Does Southern Colorado Clinic PC hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Southern Colorado Clinic PC was last updated on December 5, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.