06D1044409 CLIA NUMBER - COLORADO DEPT OF CORRECTIONS CLINICAL SERVICES

Laboratory Demographics

CLIA Number: 06D1044409

Facility Name: COLORADO DEPT OF CORRECTIONS CLINICAL SERVICES

Facility Address:
1250 ACADEMY PARK LOOP
COLORADO SPRINGS, CO
ZIP 80910
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Facility Phone Number: 719 226-4510

Facility Type: Prison

Certificate Type: Waiver

NPI Number: 1487100541

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name	Field Value
CLIA Number	06D1044409
LAB Type	Prison
Facility Name	COLORADO DEPT OF CORRECTIONS CLINICAL SERVICES
Street	1250 ACADEMY PARK LOOP
City	COLORADO SPRINGS
State	CO
ZIP	80910
Phone	719 226-4510
CertificateType	4
CertificateEffectiveDate	8/16/2023
CertificateExpirationDate	8/15/2025
FacilityType	Waiver

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