32D2005527 CLIA NUMBER - SMITHS PHARMACY #459

Laboratory Demographics

  • CLIA Code: 32D2005527
  • Facility Name: SMITHS PHARMACY #459
  • Facility Address: 8100 WYOMING BLVD NE SUITE A
    ALBUQUERQUE, NM
    ZIP 87109
  • Facility Phone: 505 857-9783
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JAIME MONTOURO
  • NPI Number: 1265457899
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 32D2005527
LAB Type Pharmacy
Facility Name SMITHS PHARMACY #459
Street 8100 WYOMING BLVD NE SUITE A
City ALBUQUERQUE
State NM
ZIP 87109
Phone 505 857-9783
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/30/2024
Certificate Expiration Date 3/29/2026
Facility Type Pharmacy
Lab Director JAIME MONTOURO

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This page was last updated on: 3/20/2025