06D0683010 CLIA NUMBER - ALPINE MEDICAL GROUP CO MAYFAIR INTERNAL MEDICINE

Laboratory Demographics

  • CLIA Code: 06D0683010
  • Facility Name: ALPINE MEDICAL GROUP CO MAYFAIR INTERNAL MEDICINE
  • Facility Address: 6311 E 14TH ST
    DENVER, CO
    ZIP 80220
  • Facility Phone: 303 333-6434
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DAVID L. BOLSHOUN
  • NPI Number: 1447466073
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 06D0683010
LAB Type Physician Office
Facility Name ALPINE MEDICAL GROUP CO MAYFAIR INTERNAL MEDICINE
Street 6311 E 14TH ST
City DENVER
State CO
ZIP 80220
Phone 303 333-6434
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 12/25/2023
Certificate Expiration Date 12/24/2025
Facility Type Physician Office
Lab Director DAVID L. BOLSHOUN

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