32D0893870 CLIA NUMBER - JEMEZ HEALTH AND HUMAN SERVICES

Laboratory Demographics

CLIA Number: 32D0893870

Facility Name: JEMEZ HEALTH AND HUMAN SERVICES

Facility Address:
110 SHEEP SPRINGS WAY
JEMEZ PUEBLO, NM
ZIP 87024
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Facility Phone Number: 575 834-7413

Facility Type: Other - TRIBAL-638 AMBULATORY CAR

Certificate Type: Microscopy

NPI Number: 1477676567

Taxonomy: 261QP0904X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	32D0893870
LAB Type	Other - TRIBAL-638 AMBULATORY CAR
Facility Name	JEMEZ HEALTH AND HUMAN SERVICES
Street	110 SHEEP SPRINGS WAY
City	JEMEZ PUEBLO
State	NM
ZIP	87024
Phone	575 834-7413
CertificateType	3
CertificateEffectiveDate	4/25/2024
CertificateExpirationDate	4/24/2026
FacilityType	PPMP

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