32D0973822 CLIA NUMBER - ROBERT L NICHOLS MD PC

Laboratory Demographics

  • CLIA Code: 32D0973822
  • Facility Name: ROBERT L NICHOLS MD PC
  • Facility Address: 1300 COUNTRY CLUB ROAD SUITE D
    SANTA TERESA, NM
    ZIP 88008
  • Facility Phone: 575 589-4000
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROBERT L. NICHOLS MD PC
  • NPI Number: 1679634562
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 32D0973822
LAB Type Physician Office
Facility Name ROBERT L NICHOLS MD PC
Street 1300 COUNTRY CLUB ROAD SUITE D
City SANTA TERESA
State NM
ZIP 88008
Phone 575 589-4000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/22/2024
Certificate Expiration Date 5/21/2026
Facility Type Physician Office
Lab Director ROBERT L. NICHOLS MD PC

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