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NPI Code Detail

MEDICARE: COLORADO DIAGNOSTICS LAB LLC

MEDICARE: COLORADO DIAGNOSTICS LAB LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QR0200XRadiology Clinic/Center

General Provider Information

NPI Number : 1255263216
Entity Type Code : Organization
Provider Name (Legal Business Name) : COLORADO DIAGNOSTICS LAB LLC
Provider Business Mailing Address
First Line : 2257 MAIN AVE
Second Line :
City : DURANGO
State : CO
Zip : 81301-4660
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2257 MAIN AVE
Second Line :
City : DURANGO
State : CO
Zip : 81301-4660
Country : US
Telephone Number : 303-578-5603
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MUHAMMAD ASIF
Credential :
Telephone Number : 214-447-7638
Provider Enumeration Date : 06/02/2026
Last Update Date : 06/02/2026

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Directions to “COLORADO DIAGNOSTICS LAB LLC ” Practice Location

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