06D2288965 CLIA NUMBER - CUSTER COUNTY PUBLIC HEALTH

Laboratory Demographics

CLIA Number: 06D2288965

Facility Name: CUSTER COUNTY PUBLIC HEALTH

Facility Address:
10 HERMIT LANE UNIT 5
SILVER CLIFF, CO
ZIP 81252
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Facility Phone Number: 719 783-3369

Facility Type: Other - PUBLIC HEALTH

Certificate Type: Waiver

NPI Number: 1528583291

Taxonomy: 251K00000X - Public Health or Welfare

CLIA Record

Field Name	Field Value
CLIA Number	06D2288965
LAB Type	Other - PUBLIC HEALTH
Facility Name	CUSTER COUNTY PUBLIC HEALTH
Street	10 HERMIT LANE UNIT 5
City	SILVER CLIFF
State	CO
ZIP	81252
Phone	719 783-3369
CertificateType	4
CertificateEffectiveDate	9/1/2023
CertificateExpirationDate	8/31/2025
FacilityType	Waiver

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