06D1060170 CLIA NUMBER - PRAIRIE VIEW RURAL HEALTH CLINIC

Laboratory Demographics

  • CLIA Code: 06D1060170
  • Facility Name: PRAIRIE VIEW RURAL HEALTH CLINIC
  • Facility Address: 615 W 5TH ST NORTH
    CHEYENNE WELLS, CO
    ZIP 80810
  • Facility Phone: (719) 767-5661
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: DR. BRIAN Z. MILES
  • NPI Number: 1003067349
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 06D1060170
LAB Type Rural Health Clinic
Facility Name PRAIRIE VIEW RURAL HEALTH CLINIC
Street 615 W 5TH ST NORTH
City CHEYENNE WELLS
State CO
ZIP 80810
Phone 7197675661
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/29/2024
Certificate Expiration Date 9/28/2026
Facility Type Rural Health Clinic
Lab Director DR. BRIAN Z. MILES

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This page was last updated on: 6/29/2026