32D0715981 CLIA NUMBER - MORA VALLEY COMMUNITY HEALTH SERVICES INC

Laboratory Demographics

CLIA Number: 32D0715981

Facility Name: MORA VALLEY COMMUNITY HEALTH SERVICES INC

Facility Address:
3 MORA VALLEY CLINIC ROAD
MORA, NM
ZIP 87732
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Facility Phone Number: 575 387-2201

Facility Type: Federally Qualified Health Center

Certificate Type: Microscopy

NPI Number: 1396104964

Taxonomy: 261QS1000X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	32D0715981
LAB Type	Federally Qualified Health Center
Facility Name	MORA VALLEY COMMUNITY HEALTH SERVICES INC
Street	3 MORA VALLEY CLINIC ROAD
City	MORA
State	NM
ZIP	87732
Phone	575 387-2201
CertificateType	3
CertificateEffectiveDate	5/1/2023
CertificateExpirationDate	4/30/2025
FacilityType	PPMP

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