06D2103027 CLIA NUMBER - PENRAD IMAGING AT BROADMOOR COMMONS

Laboratory Demographics

  • CLIA Code: 06D2103027
  • Facility Name: PENRAD IMAGING AT BROADMOOR COMMONS
  • Facility Address: 1263 LAKE PLAZA DRIVE
    COLORADO SPRINGS, CO
    ZIP 80906
  • Facility Phone: (719) 785-9000
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TIMOTHY J. SAXTON
  • NPI Number: 1275134611
  • Taxonomy: 261QR0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 06D2103027
LAB Type Physician Office
Facility Name PENRAD IMAGING AT BROADMOOR COMMONS
Street 1263 LAKE PLAZA DRIVE
City COLORADO SPRINGS
State CO
ZIP 80906
Phone 7197859000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/5/2025
Certificate Expiration Date 10/4/2027
Facility Type Physician Office
Lab Director TIMOTHY J. SAXTON

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This page was last updated on: 5/18/2026