06D2262143 CLIA NUMBER - FOUNTAIN VALLEY HEALTH CARE

Laboratory Demographics

CLIA Number: 06D2262143

Facility Name: FOUNTAIN VALLEY HEALTH CARE

Facility Address:
3808 NORTH NEVADA AVE
COLORADO SPRINGS, CO
ZIP 80908
Get Directions

Facility Phone Number: 719 726-0002

Facility Type: Community Clinic

Certificate Type: Waiver

NPI Number: 1275272924

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	06D2262143
LAB Type	Community Clinic
Facility Name	FOUNTAIN VALLEY HEALTH CARE
Street	3808 NORTH NEVADA AVE
City	COLORADO SPRINGS
State	CO
ZIP	80908
Phone	719 726-0002
CertificateType	4
CertificateEffectiveDate	6/9/2022
CertificateExpirationDate	6/8/2024
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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