32D0712903 CLIA NUMBER - WOMEN'S PELVIC SPECIALTY CARE OF NEW MEXICO

Laboratory Demographics

CLIA Number: 32D0712903

Facility Name: WOMEN'S PELVIC SPECIALTY CARE OF NEW MEXICO

Facility Address:
6621 GULTON CT NE
ALBUQUERQUE, NM
ZIP 87109
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Facility Phone Number: 505 888-0443

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1659525335

Taxonomy: 261QM2500X - Clinic/Center
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).

CLIA Record

Field Name	Field Value
CLIA Number	32D0712903
LAB Type	Physician Office
Facility Name	WOMEN'S PELVIC SPECIALTY CARE OF NEW MEXICO
Street	6621 GULTON CT NE
City	ALBUQUERQUE
State	NM
ZIP	87109
Phone	505 888-0443
CertificateType	3
CertificateEffectiveDate	3/9/2024
CertificateExpirationDate	3/8/2026
FacilityType	PPMP

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This page was last updated on: 4/23/2024