32D0536704 CLIA NUMBER - LOS ALAMOS PEDIATRIC CLINIC, PC

Laboratory Demographics

  • CLIA Code: 32D0536704
  • Facility Name: LOS ALAMOS PEDIATRIC CLINIC, PC
  • Facility Address: 3917 WEST ROAD STE 136
    LOS ALAMOS, NM
    ZIP 87544
  • Facility Phone: 505 662-9620
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JACQUELINE A. KROHN
  • NPI Number: 1245248830
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 32D0536704
LAB Type Physician Office
Facility Name LOS ALAMOS PEDIATRIC CLINIC, PC
Street 3917 WEST ROAD STE 136
City LOS ALAMOS
State NM
ZIP 87544
Phone 505 662-9620
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/20/2024
Certificate Expiration Date 12/19/2026
Facility Type Physician Office
Lab Director JACQUELINE A. KROHN

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This page was last updated on: 9/29/2025