06D2107743 CLIA NUMBER - JAYWALKER LODGE

Laboratory Demographics

  • CLIA Code: 06D2107743
  • Facility Name: JAYWALKER LODGE
  • Facility Address: 811 MAIN COURT
    CARBONDALE, CO
    ZIP 81623
  • Facility Phone: 970 704-9292
  • Facility Type: Other - RESIDENTIAL ADDICTION TRT
  • Facility Type: Waiver
  • Lab Director: WILLIAM ANUSZEWSKI
  • NPI Number: 1972901080
  • Taxonomy: 261QR0405X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 06D2107743
LAB Type Other - RESIDENTIAL ADDICTION TRT
Facility Name JAYWALKER LODGE
Street 811 MAIN COURT
City CARBONDALE
State CO
ZIP 81623
Phone 970 704-9292
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/21/2024
Certificate Expiration Date 1/20/2026
Facility Type Other - RESIDENTIAL ADDICTION TRT
Lab Director WILLIAM ANUSZEWSKI

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