32D1103934 CLIA NUMBER - EDGEWOOD PEDIATRIC CLINIC

Laboratory Demographics

  • CLIA Code: 32D1103934
  • Facility Name: EDGEWOOD PEDIATRIC CLINIC
  • Facility Address: 02 EUNICE COURT BUILDING B
    EDGEWOOD, NM
    ZIP 87015
  • Facility Phone: 505 281-4620
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SHARON D. GARNARD M D
  • NPI Number: 1699905927
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 32D1103934
LAB Type Physician Office
Facility Name EDGEWOOD PEDIATRIC CLINIC
Street 02 EUNICE COURT BUILDING B
City EDGEWOOD
State NM
ZIP 87015
Phone 505 281-4620
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/21/2025
Certificate Expiration Date 8/20/2027
Facility Type Physician Office
Lab Director SHARON D. GARNARD M D

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