06D2174042 CLIA NUMBER - COLORADO MOUNTAIN MEDICAL, LLC

Laboratory Demographics

CLIA Number: 06D2174042

Facility Name: COLORADO MOUNTAIN MEDICAL, LLC

Facility Address:
50 BUCK CREEK ROAD #300
AVON, CO
ZIP 81620
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Facility Phone Number: 970 926-6340

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1083675102

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	06D2174042
LAB Type	Physician Office
Facility Name	COLORADO MOUNTAIN MEDICAL, LLC
Street	50 BUCK CREEK ROAD #300
City	AVON
State	CO
ZIP	81620
Phone	970 926-6340
CertificateType	4
CertificateEffectiveDate	2/13/2023
CertificateExpirationDate	2/12/2025
FacilityType	Waiver

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