06D1077546 CLIA NUMBER - FRONT RANGE ENDOSCOPY CENTER, LLVC

Laboratory Demographics

  • CLIA Code: 06D1077546
  • Facility Name: FRONT RANGE ENDOSCOPY CENTER, LLVC
  • Facility Address: 719 N CASCADE AVE
    COLORADO SPRINGS, CO
    ZIP 80903
  • Facility Phone: 719 433-7224
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DR. AMANDA C. MIZICKO
  • NPI Number: 1962609560
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 06D1077546
LAB Type Ambulatory Surgery Center
Facility Name FRONT RANGE ENDOSCOPY CENTER, LLVC
Street 719 N CASCADE AVE
City COLORADO SPRINGS
State CO
ZIP 80903
Phone 719 433-7224
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/12/2023
Certificate Expiration Date 12/11/2025
Facility Type Ambulatory Surgery Center
Lab Director DR. AMANDA C. MIZICKO

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