06D2206309 CLIA NUMBER - CROSSROADS DENTAL

Laboratory Demographics

  • CLIA Code: 06D2206309
  • Facility Name: CROSSROADS DENTAL
  • Facility Address: 1520 S HOVER ST, #E-F
    LONGMONT, CO
    ZIP 80501
  • Facility Phone: 303 776-1480
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: AMY E. FARMER
  • NPI Number: 1407167836
  • Taxonomy: 261QD0000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 06D2206309
LAB Type Practitioner Other
Facility Name CROSSROADS DENTAL
Street 1520 S HOVER ST, #E-F
City LONGMONT
State CO
ZIP 80501
Phone 303 776-1480
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/18/2024
Certificate Expiration Date 12/17/2026
Facility Type Practitioner Other
Lab Director AMY E. FARMER

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