32D0673748 CLIA NUMBER - SAMIR K KASSICIEH DO

Laboratory Demographics

  • CLIA Code: 32D0673748
  • Facility Name: SAMIR K KASSICIEH DO
  • Facility Address: 1010 BRIDGE BLVD SW SUITE A
    ALBUQUERQUE, NM
    ZIP 87105
  • Facility Phone: 505 877-0212
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: DR. SAMIR K. KASSICIEH
  • NPI Number: 1730254350
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 32D0673748
LAB Type Practitioner Other
Facility Name SAMIR K KASSICIEH DO
Street 1010 BRIDGE BLVD SW SUITE A
City ALBUQUERQUE
State NM
ZIP 87105
Phone 505 877-0212
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Practitioner Other
Lab Director DR. SAMIR K. KASSICIEH

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