32D0977366 CLIA NUMBER - MESA FAMILY PRACTICE

Laboratory Demographics

  • CLIA Code: 32D0977366
  • Facility Name: MESA FAMILY PRACTICE
  • Facility Address: 2130-A FARMINGTON AVENUE
    FARMINGTON, NM
    ZIP 87401
  • Facility Phone: 505 325-2323
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: MATTHEW T. DEKAY
  • NPI Number: 1881714632
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 32D0977366
LAB Type Physician Office
Facility Name MESA FAMILY PRACTICE
Street 2130-A FARMINGTON AVENUE
City FARMINGTON
State NM
ZIP 87401
Phone 505 325-2323
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 8/24/2024
Certificate Expiration Date 8/23/2026
Facility Type Physician Office
Lab Director MATTHEW T. DEKAY

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