32D2020994 CLIA NUMBER - TIMOTHY D PETERSON MDPC DBA MOGUL MED UC

Laboratory Demographics

  • CLIA Code: 32D2020994
  • Facility Name: TIMOTHY D PETERSON MDPC DBA MOGUL MED UC
  • Facility Address: 5 FIREHOUSE ROAD
    TAOS SKI VALLEY, NM
    ZIP 87525
  • Facility Phone: 575 776-8421
  • Facility Type: Other - URGENT
  • Facility Type: Waiver
  • Lab Director: DR. LINDA C. LYNCH
  • NPI Number: 1073818555
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 32D2020994
LAB Type Other - URGENT
Facility Name TIMOTHY D PETERSON MDPC DBA MOGUL MED UC
Street 5 FIREHOUSE ROAD
City TAOS SKI VALLEY
State NM
ZIP 87525
Phone 575 776-8421
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/3/2025
Certificate Expiration Date 3/2/2027
Facility Type Other - URGENT
Lab Director DR. LINDA C. LYNCH

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