06D2255924 CLIA NUMBER - UCHEALTH IMAGING - LONGS PEAK MEDICAL CENTER

Laboratory Demographics

  • CLIA Code: 06D2255924
  • Facility Name: UCHEALTH IMAGING - LONGS PEAK MEDICAL CENTER
  • Facility Address: 1760 E KEN PRATT BLVD, STE 101
    LONGMONT, CO
    ZIP 80504
  • Facility Phone: 720 718-5100
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PAUL F. GRIBBEN
  • NPI Number: 1578218723
  • Taxonomy: 261QR0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 06D2255924
LAB Type Physician Office
Facility Name UCHEALTH IMAGING - LONGS PEAK MEDICAL CENTER
Street 1760 E KEN PRATT BLVD, STE 101
City LONGMONT
State CO
ZIP 80504
Phone 720 718-5100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/18/2024
Certificate Expiration Date 3/17/2026
Facility Type Physician Office
Lab Director PAUL F. GRIBBEN

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