06D2032458 CLIA NUMBER - WESTERN ORTHOPEDICS AND SPORTS MEDICINE

Laboratory Demographics

CLIA Number: 06D2032458

Facility Name: WESTERN ORTHOPEDICS AND SPORTS MEDICINE

Facility Address:
2373 G ROAD, SUITE 100
GRAND JUNCTION, CO
ZIP 81505
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Facility Phone Number: 970 245-0484

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1003319492

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name Field Value
CLIA Number 06D2032458
LAB Type Physician Office
Facility Name WESTERN ORTHOPEDICS AND SPORTS MEDICINE
Street 2373 G ROAD, SUITE 100
City GRAND JUNCTION
State CO
ZIP 81505
Phone 970 245-0484
CertificateType 4
CertificateEffectiveDate 11/9/2023
CertificateExpirationDate 11/8/2025
FacilityType Waiver

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