06D1035865 CLIA NUMBER - PARK AVENUE SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 06D1035865
  • Facility Name: PARK AVENUE SURGERY CENTER
  • Facility Address: 1800 EMERSON ST SUITE 220
    DENVER, CO
    ZIP 80218
  • Facility Phone: 303 468-8844
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: JERRY K. POPHAM
  • NPI Number: 1225162134
  • Taxonomy: 174400000X - Specialist

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CLIA Record

Field Name Field Value
CLIA Number 06D1035865
LAB Type Ambulatory Surgery Center
Facility Name PARK AVENUE SURGERY CENTER
Street 1800 EMERSON ST SUITE 220
City DENVER
State CO
ZIP 80218
Phone 303 468-8844
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/13/2025
Certificate Expiration Date 1/12/2027
Facility Type Ambulatory Surgery Center
Lab Director JERRY K. POPHAM

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