32D0965933 CLIA NUMBER - ENDOSCOPY CENTER OF SANTA FE

Laboratory Demographics

CLIA Number: 32D0965933

Facility Name: ENDOSCOPY CENTER OF SANTA FE

Facility Address:
1630 HOSPITAL DRIVE SUITE A
SANTA FE, NM
ZIP 87505
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Facility Phone Number: 505 988-3373

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1548249675

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	32D0965933
LAB Type	Ambulatory Surgery Center
Facility Name	ENDOSCOPY CENTER OF SANTA FE
Street	1630 HOSPITAL DRIVE SUITE A
City	SANTA FE
State	NM
ZIP	87505
Phone	505 988-3373
CertificateType	4
CertificateEffectiveDate	10/4/2023
CertificateExpirationDate	10/3/2025
FacilityType	Waiver

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