06D2085659 CLIA NUMBER - BANNER HEALTH PHYSICIANS COLORADO, LLC

Laboratory Demographics

  • CLIA Code: 06D2085659
  • Facility Name: BANNER HEALTH PHYSICIANS COLORADO, LLC
  • Facility Address: 2555 E 13TH ST, STE 230
    LOVELAND, CO
    ZIP 80537
  • Facility Phone: 970 203-2475
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. JAMES W. WOLACH
  • NPI Number: 1730598749
  • Taxonomy: 261QM1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 06D2085659
LAB Type Physician Office
Facility Name BANNER HEALTH PHYSICIANS COLORADO, LLC
Street 2555 E 13TH ST, STE 230
City LOVELAND
State CO
ZIP 80537
Phone 970 203-2475
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 10/20/2024
Certificate Expiration Date 10/19/2026
Facility Type Physician Office
Lab Director DR. JAMES W. WOLACH

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This page was last updated on: 6/4/2025