06D1078365 CLIA NUMBER - FIRESTONE CLINIC

Laboratory Demographics

  • CLIA Code: 06D1078365
  • Facility Name: FIRESTONE CLINIC
  • Facility Address: 8350 COLORADO BLVD, STE 160
    FIRESTONE, CO
    ZIP 80504
  • Facility Phone: 303 689-5160
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. THOMAS D. MINO III
  • NPI Number: 1568070944
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 06D1078365
LAB Type Physician Office
Facility Name FIRESTONE CLINIC
Street 8350 COLORADO BLVD, STE 160
City FIRESTONE
State CO
ZIP 80504
Phone 303 689-5160
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/22/2025
Certificate Expiration Date 2/21/2027
Facility Type Physician Office
Lab Director DR. THOMAS D. MINO III

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