06D2246435 CLIA NUMBER - NCWOC HEALTHCARE

Laboratory Demographics

CLIA Number: 06D2246435

Facility Name: NCWOC HEALTHCARE

Facility Address:
1501 MOUNTAIN VIEW AVE
LONGMONT, CO
ZIP 80501
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Facility Phone Number: 720 680-0018

Facility Type: Practitioner Other

Certificate Type: Waiver

NPI Number: 1134735335

Taxonomy: 261QM1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	06D2246435
LAB Type	Practitioner Other
Facility Name	NCWOC HEALTHCARE
Street	1501 MOUNTAIN VIEW AVE
City	LONGMONT
State	CO
ZIP	80501
Phone	720 680-0018
CertificateType	4
CertificateEffectiveDate	12/27/2023
CertificateExpirationDate	12/26/2025
FacilityType	Waiver

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