06D2082479 CLIA NUMBER - EVERSIDE HEALTH BOULDER GOOSE CREEK

Laboratory Demographics

  • CLIA Code: 06D2082479
  • Facility Name: EVERSIDE HEALTH BOULDER GOOSE CREEK
  • Facility Address: 2880 FOLSOM ST, STE 104
    BOULDER, CO
    ZIP 80304
  • Facility Phone: 720 536-0706
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. NICHOLEE THEISS
  • NPI Number: 1548634165
  • Taxonomy: 207Q00000X - Family Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 06D2082479
LAB Type Physician Office
Facility Name EVERSIDE HEALTH BOULDER GOOSE CREEK
Street 2880 FOLSOM ST, STE 104
City BOULDER
State CO
ZIP 80304
Phone 720 536-0706
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 8/15/2024
Certificate Expiration Date 8/14/2026
Facility Type Physician Office
Lab Director DR. NICHOLEE THEISS

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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