06D0887401 CLIA NUMBER - PREMISE HEALTH OF COLORADO DBA USAA HEALTH SERVICES

Laboratory Demographics

CLIA Number: 06D0887401

Facility Name: PREMISE HEALTH OF COLORADO DBA USAA HEALTH SERVICES

Facility Address:
1855 TELSTAR DRIVE
COLORADO SPRINGS, CO
ZIP 80920
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Facility Phone Number: 719 533-8586

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1164953154

Taxonomy: 261QM1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	06D0887401
LAB Type	Physician Office
Facility Name	PREMISE HEALTH OF COLORADO DBA USAA HEALTH SERVICES
Street	1855 TELSTAR DRIVE
City	COLORADO SPRINGS
State	CO
ZIP	80920
Phone	719 533-8586
CertificateType	4
CertificateEffectiveDate	1/27/2023
CertificateExpirationDate	1/26/2025
FacilityType	Waiver

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