06D2071230 CLIA NUMBER - EVERSIDE HEALTH WALL STREET

Laboratory Demographics

  • CLIA Code: 06D2071230
  • Facility Name: EVERSIDE HEALTH WALL STREET
  • Facility Address: 6475 WALL STREET, SUITE 120
    COLORADO SPRINGS, CO
    ZIP 80918
  • Facility Phone: 719 380-7135
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: HILLARY EICKHOFF
  • NPI Number: 1821462458
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 06D2071230
LAB Type Physician Office
Facility Name EVERSIDE HEALTH WALL STREET
Street 6475 WALL STREET, SUITE 120
City COLORADO SPRINGS
State CO
ZIP 80918
Phone 719 380-7135
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 1/7/2024
Certificate Expiration Date 1/6/2026
Facility Type Physician Office
Lab Director HILLARY EICKHOFF

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