Healthcare Provider Details

I. General information

NPI: 1568394526
Provider Name (Legal Business Name): COLORADO DIAGNOSTICS LAB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2257 MAIN AVE
DURANGO CO
81301-4660
US

IV. Provider business mailing address

2257 MAIN AVE
DURANGO CO
81301-4660
US

V. Phone/Fax

Practice location:
  • Phone: 303-578-5603
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MUHAMMAD ASIF
Title or Position: OWNER
Credential:
Phone: 214-447-7638