06D0979772 CLIA NUMBER - CENTENNIAL FAMILY CARE PC

Laboratory Demographics

  • CLIA Code: 06D0979772
  • Facility Name: CENTENNIAL FAMILY CARE PC
  • Facility Address: 7261 SOUTH BROADWAY SUITE 101A
    LITTLETON, CO
    ZIP 80122
  • Facility Phone: 303 471-2466
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: ANGELIQUE G. POTURALSKI
  • NPI Number: 1710348818
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 06D0979772
LAB Type Physician Office
Facility Name CENTENNIAL FAMILY CARE PC
Street 7261 SOUTH BROADWAY SUITE 101A
City LITTLETON
State CO
ZIP 80122
Phone 303 471-2466
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 10/31/2024
Certificate Expiration Date 10/30/2026
Facility Type Physician Office
Lab Director ANGELIQUE G. POTURALSKI

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