06D0515824 CLIA NUMBER - MOUNTAIN VISTA CHIROPRACTIC

Laboratory Demographics

  • CLIA Code: 06D0515824
  • Facility Name: MOUNTAIN VISTA CHIROPRACTIC
  • Facility Address: 421 21ST AVE STE 41
    LONGMONT, CO
    ZIP 80501
  • Facility Phone: 303 772-9600
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROBERT M. MASTELLER
  • NPI Number: 1669963997
  • Taxonomy: 235Z00000X - Speech-Language Pathologist

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CLIA Record

Field Name Field Value
CLIA Number 06D0515824
LAB Type Physician Office
Facility Name MOUNTAIN VISTA CHIROPRACTIC
Street 421 21ST AVE STE 41
City LONGMONT
State CO
ZIP 80501
Phone 303 772-9600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/8/2024
Certificate Expiration Date 1/7/2026
Facility Type Physician Office
Lab Director ROBERT M. MASTELLER

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