06D0939918 CLIA NUMBER - FOUR CORNERS OB/GYN

Laboratory Demographics

  • CLIA Code: 06D0939918
  • Facility Name: FOUR CORNERS OB/GYN
  • Facility Address: 1 MERCADO ST SUITE 105
    DURANGO, CO
    ZIP 81301
  • Facility Phone: (970) 382-8800
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. JEUNESSE FREDRICKSON
  • NPI Number: 1861503948
  • Taxonomy: 174400000X - Specialist

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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 9703828800
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/20/2024
Certificate Expiration Date 9/19/2026
Facility Type Physician Office
Lab Director DR. JEUNESSE FREDRICKSON

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This page was last updated on: 5/18/2026