06D0684521 CLIA NUMBER - LIFE CARE CENTER OF EVERGREEN

Laboratory Demographics

  • CLIA Code: 06D0684521
  • Facility Name: LIFE CARE CENTER OF EVERGREEN
  • Facility Address: 2987 BERGEN PEAK DR
    EVERGREEN, CO
    ZIP 80439
  • Facility Phone: 303 674-4500
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: KEITH K. MULLETT
  • NPI Number: 1730274572
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 06D0684521
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name LIFE CARE CENTER OF EVERGREEN
Street 2987 BERGEN PEAK DR
City EVERGREEN
State CO
ZIP 80439
Phone 303 674-4500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director KEITH K. MULLETT

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