32D1006990 CLIA NUMBER - CORRALES FAMILY PRACTICE LLC

Laboratory Demographics

  • CLIA Code: 32D1006990
  • Facility Name: CORRALES FAMILY PRACTICE LLC
  • Facility Address: 3841 CORRALES ROAD NW
    CORRALES, NM
    ZIP 87048
  • Facility Phone: 505 792-3065
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: ALYSON P. THAL MD
  • NPI Number: 1043401508
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 32D1006990
LAB Type Physician Office
Facility Name CORRALES FAMILY PRACTICE LLC
Street 3841 CORRALES ROAD NW
City CORRALES
State NM
ZIP 87048
Phone 505 792-3065
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 6/19/2025
Certificate Expiration Date 6/18/2027
Facility Type Physician Office
Lab Director ALYSON P. THAL MD

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