06D0923415 CLIA NUMBER - OPTUM COLORADO - ROUNDHOUSE FAMILY MEDICINE

Laboratory Demographics

CLIA Number: 06D0923415

Facility Name: OPTUM COLORADO - ROUNDHOUSE FAMILY MEDICINE

Facility Address:
600 S 21ST ST, STE 100
COLORADO SPRINGS, CO
ZIP 80904
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Facility Phone Number: 719 473-1585

Facility Type: Physician Office

Certificate Type: Microscopy

CLIA Record

Field Name	Field Value
CLIA Number	06D0923415
LAB Type	Physician Office
Facility Name	OPTUM COLORADO - ROUNDHOUSE FAMILY MEDICINE
Street	600 S 21ST ST, STE 100
City	COLORADO SPRINGS
State	CO
ZIP	80904
Phone	719 473-1585
CertificateType	3
CertificateEffectiveDate	4/18/2023
CertificateExpirationDate	4/17/2025
FacilityType	PPMP

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