06D2327691 CLIA NUMBER - BANNER FORT COLLINS PCP LLC

Laboratory Demographics

  • CLIA Code: 06D2327691
  • Facility Name: BANNER FORT COLLINS PCP LLC
  • Facility Address: 3519 RICHMOND DR
    FORT COLLINS, CO
    ZIP 80526
  • Facility Phone: 970 449-0951
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: CYNTHINA VAN FAROWE
  • NPI Number: 1013707207
  • Taxonomy: 261QM1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 06D2327691
LAB Type Physician Office
Facility Name BANNER FORT COLLINS PCP LLC
Street 3519 RICHMOND DR
City FORT COLLINS
State CO
ZIP 80526
Phone 970 449-0951
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 7/28/2025
Certificate Expiration Date 7/27/2027
Facility Type Physician Office
Lab Director CYNTHINA VAN FAROWE

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