32D0653253 CLIA NUMBER - ESOTERIX GENETIC LABORATORIES LLC

Laboratory Demographics

  • CLIA Code: 32D0653253
  • Facility Name: ESOTERIX GENETIC LABORATORIES LLC
  • Facility Address: 2000 VIVIGEN WAY
    SANTA FE, NM
    ZIP 87505
  • Facility Phone: 505 438-1111
  • Facility Type: Independent
  • Facility Type: Accreditation
  • Lab Director: DR. PHILIP WYATT
  • NPI Number: 1801197256
  • Taxonomy: 291U00000X - Clinical Medical Laboratory

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CLIA Record

Field Name Field Value
CLIA Number 32D0653253
LAB Type Independent
Facility Name ESOTERIX GENETIC LABORATORIES LLC
Street 2000 VIVIGEN WAY
City SANTA FE
State NM
ZIP 87505
Phone 505 438-1111
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 2/28/2025
Certificate Expiration Date 2/27/2027
Facility Type Independent
Lab Director DR. PHILIP WYATT

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