06D0698408 CLIA NUMBER - SOUTH PARK AMBULANCE DISTRICT

Laboratory Demographics

  • CLIA Code: 06D0698408
  • Facility Name: SOUTH PARK AMBULANCE DISTRICT
  • Facility Address: 911 CASTELLO PO BOX 417
    FAIRPLAY, CO
    ZIP 80440
  • Facility Phone: 719 836-2771
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: PAUL C. MATTSON
  • NPI Number: 1811091051
  • Taxonomy: 3416L0300X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 06D0698408
LAB Type Ambulance
Facility Name SOUTH PARK AMBULANCE DISTRICT
Street 911 CASTELLO PO BOX 417
City FAIRPLAY
State CO
ZIP 80440
Phone 719 836-2771
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 Ambulance
Lab Director PAUL C. MATTSON

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