32D0537352 CLIA NUMBER - LA CASA DE BUENA SALUD, INC

Laboratory Demographics

  • CLIA Code: 32D0537352
  • Facility Name: LA CASA DE BUENA SALUD, INC
  • Facility Address: 1515 WEST FIR
    PORTALES, NM
    ZIP 88130
  • Facility Phone: 575 356-6695
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Microscopy
  • Lab Director: GIDDOL G. THOM
  • NPI Number: 1730485244
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 32D0537352
LAB Type Federally Qualified Health Center
Facility Name LA CASA DE BUENA SALUD, INC
Street 1515 WEST FIR
City PORTALES
State NM
ZIP 88130
Phone 575 356-6695
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 3/8/2025
Certificate Expiration Date 3/7/2027
Facility Type Federally Qualified Health Center
Lab Director GIDDOL G. THOM

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