32D0534886 CLIA NUMBER - PHOENIX PEDIATRICS

Laboratory Demographics

  • CLIA Code: 32D0534886
  • Facility Name: PHOENIX PEDIATRICS
  • Facility Address: 4233 MONTGOMERY BLVD NE
    ALBUQUERQUE, NM
    ZIP 87109
  • Facility Phone: 505 247-1471
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CHANTAL HANJOUL
  • NPI Number: 1700872470
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 32D0534886
LAB Type Physician Office
Facility Name PHOENIX PEDIATRICS
Street 4233 MONTGOMERY BLVD NE
City ALBUQUERQUE
State NM
ZIP 87109
Phone 505 247-1471
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/20/2024
Certificate Expiration Date 3/19/2026
Facility Type Physician Office
Lab Director CHANTAL HANJOUL

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This page was last updated on: 6/4/2025