06D2288076 CLIA NUMBER - MARILLAC CLINIC INC

Laboratory Demographics

  • CLIA Code: 06D2288076
  • Facility Name: MARILLAC CLINIC INC
  • Facility Address: 87 MERCHANT DR
    MONTROSE, CO
    ZIP 81401
  • Facility Phone: 970 200-1600
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Microscopy
  • Lab Director: DR. DAVID DREITLEIN
  • NPI Number: 1801530928
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 06D2288076
LAB Type Federally Qualified Health Center
Facility Name MARILLAC CLINIC INC
Street 87 MERCHANT DR
City MONTROSE
State CO
ZIP 81401
Phone 970 200-1600
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 8/21/2025
Certificate Expiration Date 8/20/2027
Facility Type Federally Qualified Health Center
Lab Director DR. DAVID DREITLEIN

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