06D0928407 CLIA NUMBER - MIDDLE PARK MEDICAL CENTER - KREMMLING CLINIC

Laboratory Demographics

CLIA Number: 06D0928407

Facility Name: MIDDLE PARK MEDICAL CENTER - KREMMLING CLINIC

Facility Address:
214 S 4TH ST
KREMMLING, CO
ZIP 80459
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Facility Phone Number: 970 724-3524

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1174138903

Taxonomy: 261QR1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	06D0928407
LAB Type	Physician Office
Facility Name	MIDDLE PARK MEDICAL CENTER - KREMMLING CLINIC
Street	214 S 4TH ST
City	KREMMLING
State	CO
ZIP	80459
Phone	970 724-3524
CertificateType	3
CertificateEffectiveDate	7/30/2022
CertificateExpirationDate	7/29/2024
FacilityType	PPMP

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