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06D2172508 CLIA NUMBER - CENTENNIAL STATE LAB

Laboratory Demographics

CLIA Number: 06D2172508

Facility Name: CENTENNIAL STATE LAB

Facility Address:
4775 CENTENNIAL BLVD, SUITE 120
COLORADO SPRINGS, CO
ZIP 80919
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Facility Phone Number: 719 284-3522

Facility Type: Independent

Certificate Type: Accreditation
NPI Number: 1649829987

Taxonomy: 291U00000X - Clinical Medical Laboratory
(1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology.

CLIA Record

Field Name Field Value
CLIA Number 06D2172508
LAB Type Independent
Facility Name CENTENNIAL STATE LAB
Street 4775 CENTENNIAL BLVD, SUITE 120
City COLORADO SPRINGS
State CO
ZIP 80919
Phone 719 284-3522
CertificateType 1
CertificateEffectiveDate 10/20/2023
CertificateExpirationDate 10/19/2025
FacilityType Accreditation

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