10D1016543 CLIA NUMBER - TAOS SURGICAL SPECIALTIES

Laboratory Demographics

CLIA Number: 10D1016543

Facility Name: TAOS SURGICAL SPECIALTIES

Facility Address:
1399 WEIMER RD STE 600
TAOS, NM
ZIP 87571
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Facility Phone Number: 575 751-0334

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1013115062

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	10D1016543
LAB Type	Physician Office
Facility Name	TAOS SURGICAL SPECIALTIES
Street	1399 WEIMER RD STE 600
City	TAOS
State	NM
ZIP	87571
Phone	575 751-0334
CertificateType	4
CertificateEffectiveDate	3/9/2023
CertificateExpirationDate	3/8/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024