32D0994049 CLIA NUMBER - GUADALUPE COUNTY CORRECTIONAL FACILITY

Laboratory Demographics

CLIA Number: 32D0994049

Facility Name: GUADALUPE COUNTY CORRECTIONAL FACILITY

Facility Address:
SOUTH HIGHWAY 54
SANTA ROSA, NM
ZIP 88435
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Facility Phone Number: 575 472-1108

Facility Type: Other

Certificate Type: Waiver

NPI Number: 1982749453

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name	Field Value
CLIA Number	32D0994049
LAB Type	Other
Facility Name	GUADALUPE COUNTY CORRECTIONAL FACILITY
Street	SOUTH HIGHWAY 54
City	SANTA ROSA
State	NM
ZIP	88435
Phone	575 472-1108
CertificateType	4
CertificateEffectiveDate	12/4/2023
CertificateExpirationDate	12/3/2025
FacilityType	Waiver

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