06D1096191 CLIA NUMBER - MEMORIAL HOSPITAL MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 06D1096191
  • Facility Name: MEMORIAL HOSPITAL MEDICAL CLINIC
  • Facility Address: 750 HOSPITAL LOOP
    CRAIG, CO
    ZIP 81625
  • Facility Phone: 970 826-2270
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. ELISE SULLIVAN
  • NPI Number: 1780724559
  • Taxonomy: 251E00000X - Home Health

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 06D1096191
LAB Type Physician Office
Facility Name MEMORIAL HOSPITAL MEDICAL CLINIC
Street 750 HOSPITAL LOOP
City CRAIG
State CO
ZIP 81625
Phone 970 826-2270
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 5/1/2024
Certificate Expiration Date 4/30/2026
Facility Type Physician Office
Lab Director DR. ELISE SULLIVAN

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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