32D0916190 CLIA NUMBER - CASA ANGELICA

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Field Name	Field Value
CLIA Number	32D0916190
LAB Type	Intermediate Care Facility for Mentally Retarded
Facility Name	CASA ANGELICA
Street	5629 ISLETA BOULEVARD SW
City	ALBUQUERQUE
State	NM
ZIP	87105
Phone	505 877-5763
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	6/17/2024
Certificate Expiration Date	6/16/2026
Facility Type	Intermediate Care Facility for Mentally Retarded
Lab Director	JIM DOUGLAS

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