06D0935059 CLIA NUMBER - FT COLLINS YOUTH CLINIC ELIZABETH

Laboratory Demographics

  • CLIA Code: 06D0935059
  • Facility Name: FT COLLINS YOUTH CLINIC ELIZABETH
  • Facility Address: 1200 E ELIZABETH
    FT COLLINS, CO
    ZIP 80524
  • Facility Phone: 970 267-9510
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KIRSTEN M. SAMPERA
  • NPI Number: 1376849976
  • Taxonomy: 133V00000X - Dietitian, Registered

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CLIA Record

Field Name Field Value
CLIA Number 06D0935059
LAB Type Physician Office
Facility Name FT COLLINS YOUTH CLINIC ELIZABETH
Street 1200 E ELIZABETH
City FT COLLINS
State CO
ZIP 80524
Phone 970 267-9510
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/23/2024
Certificate Expiration Date 1/22/2026
Facility Type Physician Office
Lab Director KIRSTEN M. SAMPERA

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This page was last updated on: 9/29/2025