32D0968374 CLIA NUMBER - CORONADO CARE CENTER

Laboratory Demographics

  • CLIA Code: 32D0968374
  • Facility Name: CORONADO CARE CENTER
  • Facility Address: 1604 W 18TH ST
    PORTALES, NM
    ZIP 88130
  • Facility Phone: 575 359-4719
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: RANELLE TWEEDY
  • NPI Number: 1770817447
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 32D0968374
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name CORONADO CARE CENTER
Street 1604 W 18TH ST
City PORTALES
State NM
ZIP 88130
Phone 575 359-4719
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/9/2023
Certificate Expiration Date 12/8/2025
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director RANELLE TWEEDY

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