06D2145039 CLIA NUMBER - PEDIATRIC ASSOCIATES

Laboratory Demographics

  • CLIA Code: 06D2145039
  • Facility Name: PEDIATRIC ASSOCIATES
  • Facility Address: 906 SOUTH 4TH ST
    MONTROSE, CO
    ZIP 81401
  • Facility Phone: 970 249-2421
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. ROMEO ICASIANO
  • NPI Number: 1033614334
  • Taxonomy: 2080A0000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 06D2145039
LAB Type Physician Office
Facility Name PEDIATRIC ASSOCIATES
Street 906 SOUTH 4TH ST
City MONTROSE
State CO
ZIP 81401
Phone 970 249-2421
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/27/2024
Certificate Expiration Date 2/26/2026
Facility Type Physician Office
Lab Director DR. ROMEO ICASIANO

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