06D2220880 CLIA NUMBER - CARBON VALLEY EYE CARE

Laboratory Demographics

  • CLIA Code: 06D2220880
  • Facility Name: CARBON VALLEY EYE CARE
  • Facility Address: 5900 KEYES ST, SUITE 101
    FREDERICK, CO
    ZIP 80504
  • Facility Phone: 303 833-1056
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: DR. TAYLOR K. JACKSON
  • NPI Number: 1235558065
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 06D2220880
LAB Type Practitioner Other
Facility Name CARBON VALLEY EYE CARE
Street 5900 KEYES ST, SUITE 101
City FREDERICK
State CO
ZIP 80504
Phone 303 833-1056
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/15/2025
Certificate Expiration Date 4/14/2027
Facility Type Practitioner Other
Lab Director DR. TAYLOR K. JACKSON

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