06D2084674 CLIA NUMBER - DRY CREEK SURGERY

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Laboratory Demographics

CLIA Number: 06D2084674

Facility Name: DRY CREEK SURGERY

Facility Address:
125 INVERNESS DR EAST, SUITE 100
ENGLEWOOD, CO
ZIP 80112
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Facility Phone Number: 303 773-8228

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1619938636

Taxonomy: 261QS0112X - Clinic/Center
An oral and maxillofacial surgery clinic or center specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

CLIA Record

Field Name	Field Value
CLIA Number	06D2084674
LAB Type	Physician Office
Facility Name	DRY CREEK SURGERY
Street	125 INVERNESS DR EAST, SUITE 100
City	ENGLEWOOD
State	CO
ZIP	80112
Phone	303 773-8228
CertificateType	4
CertificateEffectiveDate	9/29/2022
CertificateExpirationDate	9/28/2024
FacilityType	Waiver

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