06D2021354 CLIA NUMBER - PEDIATRIC ASSOCIATES

Laboratory Demographics

  • CLIA Code: 06D2021354
  • Facility Name: PEDIATRIC ASSOCIATES
  • Facility Address: 242 COTTONWOOD ST STE 101
    DELTA, CO
    ZIP 81416
  • Facility Phone: 970 874-7552
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. ROMEO G. ICASIANO
  • NPI Number: 1831694231
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 06D2021354
LAB Type Physician Office
Facility Name PEDIATRIC ASSOCIATES
Street 242 COTTONWOOD ST STE 101
City DELTA
State CO
ZIP 81416
Phone 970 874-7552
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/11/2025
Certificate Expiration Date 3/10/2027
Facility Type Physician Office
Lab Director DR. ROMEO G. ICASIANO

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