06D1080809 CLIA NUMBER - MIDVALLEY FAMILY PRACTICE

Laboratory Demographics

CLIA Number: 06D1080809

Facility Name: MIDVALLEY FAMILY PRACTICE

Facility Address:
1450 E VALLEY ROAD #102
BASALT, CO
ZIP 81621
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Facility Phone Number: 970 927-4666

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1568559748

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	06D1080809
LAB Type	Physician Office
Facility Name	MIDVALLEY FAMILY PRACTICE
Street	1450 E VALLEY ROAD #102
City	BASALT
State	CO
ZIP	81621
Phone	970 927-4666
CertificateType	4
CertificateEffectiveDate	3/3/2024
CertificateExpirationDate	3/2/2026
FacilityType	Waiver

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