06D0515326 CLIA NUMBER - BOULDER VALLEY ASTHMA AND ALLERGY

Laboratory Demographics

  • CLIA Code: 06D0515326
  • Facility Name: BOULDER VALLEY ASTHMA AND ALLERGY
  • Facility Address: 3950 BROADWAY STREET
    BOULDER, CO
    ZIP 80304
  • Facility Phone: 303 234-1067
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. MARK MENICH
  • NPI Number: 1801411376
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 06D0515326
LAB Type Physician Office
Facility Name BOULDER VALLEY ASTHMA AND ALLERGY
Street 3950 BROADWAY STREET
City BOULDER
State CO
ZIP 80304
Phone 303 234-1067
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/10/2024
Certificate Expiration Date 10/9/2026
Facility Type Physician Office
Lab Director DR. MARK MENICH

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This page was last updated on: 9/29/2025