06D0701735 CLIA NUMBER - STOUT STREET HEALTH CENTER

Laboratory Demographics

CLIA Number: 06D0701735

Facility Name: STOUT STREET HEALTH CENTER

Facility Address:
2130 STOUT ST
DENVER, CO
ZIP 80205
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Facility Phone Number: 303 212-9559

Facility Type: Federally Qualified Health Center

Certificate Type: Microscopy

NPI Number: 1396793030

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	06D0701735
LAB Type	Federally Qualified Health Center
Facility Name	STOUT STREET HEALTH CENTER
Street	2130 STOUT ST
City	DENVER
State	CO
ZIP	80205
Phone	303 212-9559
CertificateType	3
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	PPMP

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