32D1039469 CLIA NUMBER - FULL CIRCLE HEALING FAMILY PRACTICE LLC

Laboratory Demographics

  • CLIA Code: 32D1039469
  • Facility Name: FULL CIRCLE HEALING FAMILY PRACTICE LLC
  • Facility Address: 2019 GALISTEO ST SUITE N9A
    SANTA FE, NM
    ZIP 87505
  • Facility Phone: 505 820-1482
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. DEBRA HIGGINBOTHAM
  • NPI Number: 1134230287
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 32D1039469
LAB Type Physician Office
Facility Name FULL CIRCLE HEALING FAMILY PRACTICE LLC
Street 2019 GALISTEO ST SUITE N9A
City SANTA FE
State NM
ZIP 87505
Phone 505 820-1482
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 4/14/2025
Certificate Expiration Date 4/13/2027
Facility Type Physician Office
Lab Director DR. DEBRA HIGGINBOTHAM

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This page was last updated on: 6/4/2025