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PENRAD IMAGING LLC
NPI 1538760962
Clinic/Center - Radiology in Colorado Springs, CO

Active since November 03, 2020CLIA 06D1090667 · Waiver
6011 E WOODMEN RD STE 10, COLORADO SPRINGS, CO 80923(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: August 16, 2026.

About Penrad Imaging Llc NPPES

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

PENRAD IMAGING LLC (NPI 1538760962) 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 15, 2026 and lists Derek Scott Bergeson, Radiologist, as its authorized official.

NPPES Registry Identity

NPI1538760962
Entity TypeOrganization
Primary Taxonomy261QR0200X
Legal Business NamePENRAD IMAGING LLC
Location Address6011 E WOODMEN RD STE 10Colorado Springs, CO 80923-2603
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 1538760962 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · RadiologyAmbulatory Health Care Facilities
Taxonomy Code261QR0200X
6011 E WOODMEN RD STE 10, Colorado Springs, CO 80923
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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 06D1090667

Penrad Imaging At Sisters Grove Pavilion · Colorado Springs, CO
Active · expires Oct 15, 2026
CLIA Number06D1090667
Laboratory TypeOther
Certificate Effective DateOctober 16, 2024
Certificate Expiration DateOctober 15, 2026
Laboratory DirectorTimothy J. Saxton
Laboratory Phone(719) 785-9000
Laboratory LocationPenrad Imaging At Sisters Grove Pavilion6011 E Woodmen Rd, Ste 10, Colorado Springs, CO 80923
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 1538760962. 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 6011 E Woodmen Rd Ste 10, Colorado Springs, CO 80923. 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 06D1090667) is associated with this NPI, valid through October 15, 2026. 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.