06D2272227 CLIA NUMBER - PENCE PEDIATRICS PC

Laboratory Demographics

  • CLIA Code: 06D2272227
  • Facility Name: PENCE PEDIATRICS PC
  • Facility Address: 10 RUPERT ST, WEST ENTRANCE
    MONTE VISTA, CO
    ZIP 81144
  • Facility Phone: 719 852-3742
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. MIKAILA HELDT PENCE
  • NPI Number: 1518677020
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 06D2272227
LAB Type Physician Office
Facility Name PENCE PEDIATRICS PC
Street 10 RUPERT ST, WEST ENTRANCE
City MONTE VISTA
State CO
ZIP 81144
Phone 719 852-3742
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/16/2024
Certificate Expiration Date 11/15/2026
Facility Type Physician Office
Lab Director DR. MIKAILA HELDT PENCE

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