32D1106379 CLIA NUMBER - PINE HILL HEALTH CENTER

Laboratory Demographics

CLIA Code: 32D1106379
Facility Name: PINE HILL HEALTH CENTER
Facility Address: BIA RT 125 MP 12 5
PINEHILL, NM
ZIP 87357
Facility Phone: 505 775-3271
Facility Type: Other
Facility Type: Waiver
Lab Director: DR. JULIO CAGUNGUN
NPI Number: 1073671194
Taxonomy: 332800000X - Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy

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CLIA Record

Field Name	Field Value
CLIA Number	32D1106379
LAB Type	Other
Facility Name	PINE HILL HEALTH CENTER
Street	BIA RT 125 MP 12 5
City	PINEHILL
State	NM
ZIP	87357
Phone	505 775-3271
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	10/13/2025
Certificate Expiration Date	10/12/2027
Facility Type	Other
Lab Director	DR. JULIO CAGUNGUN

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