06D2171009 CLIA NUMBER - MEDICINE FOR BUSINESS AND INDUSTRY

Laboratory Demographics

CLIA Number: 06D2171009

Facility Name: MEDICINE FOR BUSINESS AND INDUSTRY

Facility Address:
205 S MAIN STREET, SUITE C
LONGMONT, CO
ZIP 80501
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Facility Phone Number: 303 702-1612

Facility Type: Other - OCCUPATIONAL MEDICINE

Certificate Type: Waiver

NPI Number: 1003137134

Taxonomy: 261QX0100X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	06D2171009
LAB Type	Other - OCCUPATIONAL MEDICINE
Facility Name	MEDICINE FOR BUSINESS AND INDUSTRY
Street	205 S MAIN STREET, SUITE C
City	LONGMONT
State	CO
ZIP	80501
Phone	303 702-1612
CertificateType	4
CertificateEffectiveDate	8/23/2023
CertificateExpirationDate	8/22/2025
FacilityType	Waiver

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