06D2120133 CLIA NUMBER - COLORADO DERMATOLOGY GROUP, PLLC

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Laboratory Demographics

CLIA Number: 06D2120133

Facility Name: COLORADO DERMATOLOGY GROUP, PLLC

Facility Address:
3609 S TIMBERLINE RD UNIT A
FORT COLLINS, CO
ZIP 80525
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Facility Phone Number: 970 305-4341

Facility Type: Physician Office

Certificate Type: Certificate of Compliance

NPI Number: 1467069120

Taxonomy: 2086S0129X - Surgery
A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.

CLIA Record

Field Name	Field Value
CLIA Number	06D2120133
LAB Type	Physician Office
Facility Name	COLORADO DERMATOLOGY GROUP, PLLC
Street	3609 S TIMBERLINE RD UNIT A
City	FORT COLLINS
State	CO
ZIP	80525
Phone	970 305-4341
CertificateType	2
CertificateEffectiveDate	3/10/2021
CertificateExpirationDate	4/30/2024
FacilityType	Compliance

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