32D0981157 CLIA NUMBER - VILLAGE PHARMACY INC

Laboratory Demographics

  • CLIA Code: 32D0981157
  • Facility Name: VILLAGE PHARMACY INC
  • Facility Address: 1719 SOUTH AVENUE D
    PORTALES, NM
    ZIP 88130
  • Facility Phone: 505 356-8555
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: VICTOR A. BACA
  • NPI Number: 1376676783
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 32D0981157
LAB Type Pharmacy
Facility Name VILLAGE PHARMACY INC
Street 1719 SOUTH AVENUE D
City PORTALES
State NM
ZIP 88130
Phone 505 356-8555
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/19/2024
Certificate Expiration Date 12/18/2026
Facility Type Pharmacy
Lab Director VICTOR A. BACA

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