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PENRAD IMAGING LLC
NPI 1275134611
Clinic/Center - Radiology in Colorado Springs, CO

Active since November 03, 2020CLIA 06D2103027 · Waiver
1263 LAKE PLAZA DR STE 100, COLORADO SPRINGS, CO 80906(719) 593-1799(719) 265-3794 Get Directions Write a Review

NPPES record last updated: November 3, 2020. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Penrad Imaging Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PENRAD IMAGING LLC (NPI 1275134611) is a healthcare organization registered as a radiology in Colorado Springs, Colorado and active in the NPI registry since November 2020. The organization holds a CLIA Waiver certificate valid through October 4, 2027 and lists Derek Scott Bergeson, Radiologist, as its authorized official.

NPPES Registry Identity

NPI1275134611
Entity TypeOrganization
Primary Taxonomy261QR0200X
Legal Business NamePENRAD IMAGING LLC
Location Address1263 LAKE PLAZA DR STE 100Colorado Springs, CO 80906-3510
Mailing AddressPo Box 2989Colorado Springs, CO 80901-2989 · (719) 593-1799 · Fax (719) 265-3794
Phone(719) 593-1799
Fax(719) 265-3794
Organization SubpartNo
Authorized OfficialDerek Scott BergesonRadiologist · (719) 593-1799
Enumeration DateNovember 3, 2020
NPPES CertifiedNovember 3, 2020
✔ NPI 1275134611 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · RadiologyAmbulatory Health Care Facilities
Taxonomy Code261QR0200X
1263 LAKE PLAZA DR STE 100, Colorado Springs, CO 80906
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CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 06D2103027

Penrad Imaging At Broadmoor Commons · Colorado Springs, CO
Active · expires Oct 4, 2027
CLIA Number06D2103027
Laboratory TypePhysician Office
Certificate Effective DateOctober 5, 2025
Certificate Expiration DateOctober 4, 2027
Laboratory DirectorTimothy J. Saxton
Laboratory Phone(719) 785-9000
Laboratory LocationPenrad Imaging At Broadmoor Commons1263 Lake Plaza Drive, Colorado Springs, CO 80906
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Penrad Imaging LLC's NPI number?

The NPI number for Penrad Imaging LLC is 1275134611. It was assigned to this organization in the NPPES registry on November 3, 2020.

Where is Penrad Imaging LLC located?

Penrad Imaging LLC is located at 1263 Lake Plaza Dr Ste 100, Colorado Springs, CO 80906. The listed phone number is (719) 593-1799.

What is Penrad Imaging LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Radiology, with taxonomy code 261QR0200X.

Does Penrad Imaging LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 06D2103027) is associated with this NPI, valid through October 4, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Penrad Imaging LLC was last updated on November 3, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.