06D0516682 CLIA NUMBER - BANNER HOME CARE COLORADO

Laboratory Demographics

CLIA Number: 06D0516682

Facility Name: BANNER HOME CARE COLORADO

Facility Address:
5628 W 19TH ST, SUITE 1
GREELEY, CO
ZIP 80634
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Facility Phone Number: 970 810-6222

Facility Type: Home Health Agency

Certificate Type: Waiver

NPI Number: 1104590595

Taxonomy: 251F00000X - Home Infusion

CLIA Record

Field Name	Field Value
CLIA Number	06D0516682
LAB Type	Home Health Agency
Facility Name	BANNER HOME CARE COLORADO
Street	5628 W 19TH ST, SUITE 1
City	GREELEY
State	CO
ZIP	80634
Phone	970 810-6222
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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