06D2172865 CLIA NUMBER - LIBERTY DIALYSIS - COLORADO SPRINGS WEST

Laboratory Demographics

CLIA Number: 06D2172865

Facility Name: LIBERTY DIALYSIS - COLORADO SPRINGS WEST

Facility Address:
3326 CENTENNIAL BLVD
COLORADO SPRINGS, CO
ZIP 80907
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Facility Phone Number: 719 593-2999

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1497921274

Taxonomy: 261QE0700X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	06D2172865
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	LIBERTY DIALYSIS - COLORADO SPRINGS WEST
Street	3326 CENTENNIAL BLVD
City	COLORADO SPRINGS
State	CO
ZIP	80907
Phone	719 593-2999
CertificateType	4
CertificateEffectiveDate	10/1/2023
CertificateExpirationDate	9/30/2025
FacilityType	Waiver

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