32D2020483 CLIA NUMBER - ALBERTSONS MARKET PHARMACY #920

Laboratory Demographics

  • CLIA Code: 32D2020483
  • Facility Name: ALBERTSONS MARKET PHARMACY #920
  • Facility Address: 710 A PASEO DE PUEBLO SUR, SUITE A
    TAOS, NM
    ZIP 87571
  • Facility Phone: 575 758-1203
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CRESTINA CORDOVA
  • NPI Number: 1720286156
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 32D2020483
LAB Type Pharmacy
Facility Name ALBERTSONS MARKET PHARMACY #920
Street 710 A PASEO DE PUEBLO SUR, SUITE A
City TAOS
State NM
ZIP 87571
Phone 575 758-1203
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/21/2025
Certificate Expiration Date 2/20/2027
Facility Type Pharmacy
Lab Director CRESTINA CORDOVA

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