06D1050324 CLIA NUMBER - DELTA WAVES, LLC

Laboratory Demographics

CLIA Number: 06D1050324

Facility Name: DELTA WAVES, LLC

Facility Address:
5835 LEHMAN DRIVE #101
COLORADO SPRINGS, CO
ZIP 80918
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Facility Phone Number: 719 262-9283

Facility Type: Other

Certificate Type: Waiver

NPI Number: 1679892475

Taxonomy: 261QS1200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	06D1050324
LAB Type	Other
Facility Name	DELTA WAVES, LLC
Street	5835 LEHMAN DRIVE #101
City	COLORADO SPRINGS
State	CO
ZIP	80918
Phone	719 262-9283
CertificateType	4
CertificateEffectiveDate	1/31/2024
CertificateExpirationDate	1/30/2026
FacilityType	Waiver

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