06D2241548 CLIA NUMBER - TABLE MOUNTAIN FAMILY MEDICINE

Laboratory Demographics

CLIA Number: 06D2241548

Facility Name: TABLE MOUNTAIN FAMILY MEDICINE

Facility Address:
110 NORTH RUBEY DR, SUITE 200
GOLDEN, CO
ZIP 80403
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Facility Phone Number: 303 376-0975

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1336808492

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	06D2241548
LAB Type	Physician Office
Facility Name	TABLE MOUNTAIN FAMILY MEDICINE
Street	110 NORTH RUBEY DR, SUITE 200
City	GOLDEN
State	CO
ZIP	80403
Phone	303 376-0975
CertificateType	4
CertificateEffectiveDate	10/29/2023
CertificateExpirationDate	10/28/2025
FacilityType	Waiver

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