06D2073692 CLIA NUMBER - RED CANYON FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 06D2073692
  • Facility Name: RED CANYON FAMILY MEDICINE
  • Facility Address: 455 KOKOPELLI BLVD UNIT C
    FRUITA, CO
    ZIP 81521
  • Facility Phone: 970 256-5285
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: AMY O. BRATTELI
  • NPI Number: 1972932622
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 06D2073692
LAB Type Physician Office
Facility Name RED CANYON FAMILY MEDICINE
Street 455 KOKOPELLI BLVD UNIT C
City FRUITA
State CO
ZIP 81521
Phone 970 256-5285
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 2/24/2024
Certificate Expiration Date 2/23/2026
Facility Type Physician Office
Lab Director AMY O. BRATTELI

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