06D0939918 CLIA NUMBER - FOUR CORNERS OB/GYN

Laboratory Demographics

CLIA Number: 06D0939918

Facility Name: FOUR CORNERS OB/GYN

Facility Address:
1 MERCADO ST SUITE 105
DURANGO, CO
ZIP 81301
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Facility Phone Number: 970 382-8800

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1861503948

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	06D0939918
LAB Type	Physician Office
Facility Name	FOUR CORNERS OB/GYN
Street	1 MERCADO ST SUITE 105
City	DURANGO
State	CO
ZIP	81301
Phone	970 382-8800
CertificateType	3
CertificateEffectiveDate	9/20/2022
CertificateExpirationDate	9/19/2024
FacilityType	PPMP

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