06D2120609 CLIA NUMBER - CHPG PRIMARY CARE SOUTHWEST LONGMONT

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Laboratory Demographics

CLIA Number: 06D2120609

Facility Name: CHPG PRIMARY CARE SOUTHWEST LONGMONT

Facility Address:
2101 KEN PRATT BLVD, STE 200
LONGMONT, CO
ZIP 80501
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Facility Phone Number: 303 649-3500

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1780047902

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	06D2120609
LAB Type	Physician Office
Facility Name	CHPG PRIMARY CARE SOUTHWEST LONGMONT
Street	2101 KEN PRATT BLVD, STE 200
City	LONGMONT
State	CO
ZIP	80501
Phone	303 649-3500
CertificateType	3
CertificateEffectiveDate	10/20/2022
CertificateExpirationDate	10/19/2024
FacilityType	PPMP

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