06D2088767 CLIA NUMBER - PROGRESSIVE CARE CENTER

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Laboratory Demographics

CLIA Number: 06D2088767

Facility Name: PROGRESSIVE CARE CENTER

Facility Address:
1338 PHAY AVE, BUILDING B
CANON CITY, CO
ZIP 81212
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Facility Phone Number: 719 245-1414

Facility Type: Skilled Nursing Facility/Nursing Facility

Certificate Type: Waiver

NPI Number: 1518076462

Taxonomy: 311ZA0620X - Custodial Care Facility
A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.

CLIA Record

Field Name	Field Value
CLIA Number	06D2088767
LAB Type	Skilled Nursing Facility/Nursing Facility
Facility Name	PROGRESSIVE CARE CENTER
Street	1338 PHAY AVE, BUILDING B
City	CANON CITY
State	CO
ZIP	81212
Phone	719 245-1414
CertificateType	4
CertificateEffectiveDate	12/17/2022
CertificateExpirationDate	12/16/2024
FacilityType	Waiver

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