06D0994942 CLIA NUMBER - FRONT RANGE SURGERY CENTER

Laboratory Demographics

CLIA Number: 06D0994942

Facility Name: FRONT RANGE SURGERY CENTER

Facility Address:
1610 DRY CREEK DRIVE #100
LONGMONT, CO
ZIP 80503
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Facility Phone Number: 720 494-3200

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1013114230

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	06D0994942
LAB Type	Ambulatory Surgery Center
Facility Name	FRONT RANGE SURGERY CENTER
Street	1610 DRY CREEK DRIVE #100
City	LONGMONT
State	CO
ZIP	80503
Phone	720 494-3200
CertificateType	4
CertificateEffectiveDate	1/7/2024
CertificateExpirationDate	1/6/2026
FacilityType	Waiver

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