06D1066927 CLIA NUMBER - PARK WEST IMAGING

Laboratory Demographics

  • CLIA Code: 06D1066927
  • Facility Name: PARK WEST IMAGING
  • Facility Address: 3676 PARKER BLVD STE 165
    PUEBLO, CO
    ZIP 81008
  • Facility Phone: 719 595-7611
  • Facility Type: Other - OUTPATIENT RADIOLOGY CTR
  • Facility Type: Waiver
  • Lab Director: JACQUELYNN S. SHARP
  • NPI Number: 1093233348
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 06D1066927
LAB Type Other - OUTPATIENT RADIOLOGY CTR
Facility Name PARK WEST IMAGING
Street 3676 PARKER BLVD STE 165
City PUEBLO
State CO
ZIP 81008
Phone 719 595-7611
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/5/2025
Certificate Expiration Date 4/4/2027
Facility Type Other - OUTPATIENT RADIOLOGY CTR
Lab Director JACQUELYNN S. SHARP

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