32D1099488 CLIA NUMBER - PMG ESPANOLA HOSPITAL PRESBYTERIAN HEALTH SERVICES

Laboratory Demographics

  • CLIA Code: 32D1099488
  • Facility Name: PMG ESPANOLA HOSPITAL PRESBYTERIAN HEALTH SERVICES
  • Facility Address: 1010 SPRUCE STREET
    ESPANOLA, NM
    ZIP 87532
  • Facility Phone: 505 367-0342
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. JENNIFER SHONK

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CLIA Record

Field Name Field Value
CLIA Number 32D1099488
LAB Type Physician Office
Facility Name PMG ESPANOLA HOSPITAL PRESBYTERIAN HEALTH SERVICES
Street 1010 SPRUCE STREET
City ESPANOLA
State NM
ZIP 87532
Phone 505 367-0342
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 5/14/2025
Certificate Expiration Date 5/13/2027
Facility Type Physician Office
Lab Director DR. JENNIFER SHONK

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