06D0873277 CLIA NUMBER - CANON FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 06D0873277
  • Facility Name: CANON FAMILY MEDICINE
  • Facility Address: 1210 MAIN ST
    CANON CITY, CO
    ZIP 81212
  • Facility Phone: 719 275-3000
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: ROBERT D. MCCURRY
  • NPI Number: 1790971141
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 06D0873277
LAB Type Physician Office
Facility Name CANON FAMILY MEDICINE
Street 1210 MAIN ST
City CANON CITY
State CO
ZIP 81212
Phone 719 275-3000
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 7/21/2023
Certificate Expiration Date 7/20/2025
Facility Type Physician Office
Lab Director ROBERT D. MCCURRY

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This page was last updated on: 6/4/2025