06D2134210 CLIA NUMBER - BOULDER INTEGRATED HEALTH

Laboratory Demographics

  • CLIA Code: 06D2134210
  • Facility Name: BOULDER INTEGRATED HEALTH
  • Facility Address: 2429 BROADWAY
    BOULDER, CO
    ZIP 80304
  • Facility Phone: 720 739-6500
  • Facility Type: Ancillary Testing Site in Health Care Center
  • Facility Type: Waiver
  • Lab Director: DR. IAONNUS A. MALIDELIS
  • NPI Number: 1376093898
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 06D2134210
LAB Type Ancillary Testing Site in Health Care Center
Facility Name BOULDER INTEGRATED HEALTH
Street 2429 BROADWAY
City BOULDER
State CO
ZIP 80304
Phone 720 739-6500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/27/2025
Certificate Expiration Date 7/26/2027
Facility Type Ancillary Testing Site in Health Care Center
Lab Director DR. IAONNUS A. MALIDELIS

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