06D2316161 CLIA NUMBER - NP PRIMARY WELLNESS

Laboratory Demographics

  • CLIA Code: 06D2316161
  • Facility Name: NP PRIMARY WELLNESS
  • Facility Address: 805 EAGLERIDGE BLVD, SUITE 140
    PUEBLO, CO
    ZIP 81008
  • Facility Phone: 719 966-0442
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: DARCY V. HEIM
  • NPI Number: 1730929845
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 06D2316161
LAB Type Practitioner Other
Facility Name NP PRIMARY WELLNESS
Street 805 EAGLERIDGE BLVD, SUITE 140
City PUEBLO
State CO
ZIP 81008
Phone 719 966-0442
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/30/2024
Certificate Expiration Date 12/29/2026
Facility Type Practitioner Other
Lab Director DARCY V. HEIM

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