CHAMPIONS FAMILY MEDICAL
NPI 1700322575
Legal Medicine in Pueblo, CO

Active since January 17, 2017CLIA 06D2134327 · Waiver
415 N GRAND AVE, PUEBLO, CO 81003(719) 924-8448(719) 924-9382 Get Directions Write a Review

NPPES record last updated: January 17, 2017. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Champions Family Medical NPPES

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

CHAMPIONS FAMILY MEDICAL (NPI 1700322575) is a healthcare organization registered as a legal medicine in Pueblo, Colorado and active in the NPI registry since January 2017. The organization holds a CLIA Waiver certificate valid through July 30, 2027 and lists Richard B Lane, Practice Manager, as its authorized official.

NPPES Registry Identity

NPI1700322575
Entity TypeOrganization
Primary Taxonomy173000000X
Legal Business NameCHAMPIONS FAMILY MEDICAL, PLLC
Location Address415 N GRAND AVEPueblo, CO 81003-3111
Mailing Address415 N Grand AvePueblo, CO 81003-3111 · (719) 924-8448 · Fax (719) 924-9382
Fax(719) 924-9382
Organization SubpartNo
Authorized OfficialRichard B LanePractice Manager · (719) 406-9304
Enumeration DateJanuary 17, 2017
NPI 1700322575 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyLegal MedicineOther Service Providers
Taxonomy Code173000000X
Definition

The specialty areas of medicine concerned with matters of, and relations with, substantive law and legal institutions; such as the conduct of medical examinations at crime scenes, performance of autopsies, giving of expert medical testimony in judicial proceedings, medical treatment of inmates of penal institutions, the practice of trauma medicine in law enforcement settings, and other clinical practice and medical science applications in the fields of law, law enforcement, and corrections.

415 N GRAND AVE, Pueblo, CO 81003

Other Names 1

Doing Business AsChampions Family Medical

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

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 06D2134327

Champions Family Medical, PLLC · Pueblo, CO
Active · expires Jul 30, 2027
CLIA Number06D2134327
Laboratory TypePhysician Office
Certificate Effective DateJuly 31, 2025
Certificate Expiration DateJuly 30, 2027
Laboratory DirectorErica Valdez
Laboratory Phone(719) 924-8448
Laboratory LocationChampions Family Medical, PLLC1130 Eagleridge Blvd, Pueblo, CO 81008
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

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

Nurse Practitioner (Acute Care)
415 N GRAND AVE
PUEBLO, CO 81003
Nurse Practitioner (Family)
415 N GRAND AVE
PUEBLO, CO 81003
Nurse Practitioner (Family)
415 N GRAND AVE
PUEBLO, CO 81003
Legal Medicine
415 N GRAND AVE
PUEBLO, CO 81003
Family Medicine (Adult Medicine)
415 N GRAND AVE
PUEBLO, CO 81003

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 Champions Family Medical, PLLC's NPI number?

The NPI number for Champions Family Medical, PLLC is 1700322575. It was assigned to this organization in the NPPES registry on January 17, 2017. The provider is doing business as Champions Family Medical.

Where is Champions Family Medical, PLLC located?

Champions Family Medical, PLLC is located at 415 N Grand Ave, Pueblo, CO 81003. The listed phone number is (719) 924-8448.

What is Champions Family Medical, PLLC's specialty?

The primary specialty registered for this NPI is Legal Medicine with taxonomy code 173000000X.

Does Champions Family Medical, PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 06D2134327) is associated with this NPI, valid through July 30, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Champions Family Medical, PLLC was last updated on January 17, 2017. NPI Profile syncs with the weekly NPPES data releases published by CMS.