06D1023042 CLIA NUMBER - CONCENTRA - SOUTH ACADEMY

Laboratory Demographics

  • CLIA Code: 06D1023042
  • Facility Name: CONCENTRA - SOUTH ACADEMY
  • Facility Address: 2322 S ACADEMY BLVD
    COLORADO SPRINGS, CO
    ZIP 80916
  • Facility Phone: 719 390-1727
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. DANIEL M. PETERSON
  • NPI Number: 1790974608
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 06D1023042
LAB Type Physician Office
Facility Name CONCENTRA - SOUTH ACADEMY
Street 2322 S ACADEMY BLVD
City COLORADO SPRINGS
State CO
ZIP 80916
Phone 719 390-1727
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/5/2024
Certificate Expiration Date 3/4/2026
Facility Type Physician Office
Lab Director DR. DANIEL M. PETERSON

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