06D1092844 CLIA NUMBER - VCPHCS X, LLC DBA - BHG LONGMONT TREATMENT CENTER

Laboratory Demographics

  • CLIA Code: 06D1092844
  • Facility Name: VCPHCS X, LLC DBA - BHG LONGMONT TREATMENT CENTER
  • Facility Address: 850 23RD AVE, SUITE A
    LONGMONT, CO
    ZIP 80501
  • Facility Phone: 303 245-0123
  • Facility Type: Other - SUBSTANCE ABUSE TREAMENT
  • Facility Type: Waiver
  • Lab Director: ANTOINETTE DASILVA-FAUSTO
  • NPI Number: 1073774667
  • Taxonomy: 261QR0405X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 06D1092844
LAB Type Other - SUBSTANCE ABUSE TREAMENT
Facility Name VCPHCS X, LLC DBA - BHG LONGMONT TREATMENT CENTER
Street 850 23RD AVE, SUITE A
City LONGMONT
State CO
ZIP 80501
Phone 303 245-0123
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/4/2024
Certificate Expiration Date 12/3/2026
Facility Type Other - SUBSTANCE ABUSE TREAMENT
Lab Director ANTOINETTE DASILVA-FAUSTO

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This page was last updated on: 6/4/2025