06D2132376 CLIA NUMBER - COMMUNITY DENTAL CLINIC DBA - THE PIC PLACE

Laboratory Demographics

CLIA Number: 06D2132376

Facility Name: COMMUNITY DENTAL CLINIC DBA - THE PIC PLACE

Facility Address:
87 MERCHANT DR
MONTROSE, CO
ZIP 81401
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Facility Phone Number: 970 252-8896

Facility Type: Community Clinic

Certificate Type: Microscopy

NPI Number: 1235664707

Taxonomy: 261QC1500X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	06D2132376
LAB Type	Community Clinic
Facility Name	COMMUNITY DENTAL CLINIC DBA - THE PIC PLACE
Street	87 MERCHANT DR
City	MONTROSE
State	CO
ZIP	81401
Phone	970 252-8896
CertificateType	3
CertificateEffectiveDate	6/19/2023
CertificateExpirationDate	6/18/2025
FacilityType	PPMP

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