06D0517288 CLIA NUMBER - JACK FORD, MD

Laboratory Demographics

  • CLIA Code: 06D0517288
  • Facility Name: JACK FORD, MD
  • Facility Address: 3505 AUSTIN BLUFFS PARKWAY, SUITE 306
    COLORADO SPRINGS, CO
    ZIP 80918
  • Facility Phone: 719 475-1810
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. JACK FORD
  • NPI Number: 1558363234
  • Taxonomy: 207VG0400X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 06D0517288
LAB Type Physician Office
Facility Name JACK FORD, MD
Street 3505 AUSTIN BLUFFS PARKWAY, SUITE 306
City COLORADO SPRINGS
State CO
ZIP 80918
Phone 719 475-1810
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description 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.
Certificate Effective Date 6/2/2024
Certificate Expiration Date 6/1/2026
Facility Type Physician Office
Lab Director DR. JACK FORD

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