06D2004669 CLIA NUMBER - ADVENTHEALTH SURGERY CENTER BOULDER

Laboratory Demographics

  • CLIA Code: 06D2004669
  • Facility Name: ADVENTHEALTH SURGERY CENTER BOULDER
  • Facility Address: 2525 4TH ST, STE 201
    BOULDER, CO
    ZIP 80304
  • Facility Phone: 303 269-2580
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: DR. JAMES R. PESHOCK
  • NPI Number: 1962042499
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 06D2004669
LAB Type Ambulatory Surgery Center
Facility Name ADVENTHEALTH SURGERY CENTER BOULDER
Street 2525 4TH ST, STE 201
City BOULDER
State CO
ZIP 80304
Phone 303 269-2580
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/10/2024
Certificate Expiration Date 3/9/2026
Facility Type Ambulatory Surgery Center
Lab Director DR. JAMES R. PESHOCK

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