32D2030128 CLIA NUMBER - UNM DENTAL SERVICES CAMINO DE SALUD RESIDENCY CLINIC

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Laboratory Demographics

CLIA Number: 32D2030128

Facility Name: UNM DENTAL SERVICES CAMINO DE SALUD RESIDENCY CLINIC

Facility Address:
1801 CAMINO DE SALUD NE
ALBUQUERQUE, NM
ZIP 87102
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Facility Phone Number: 505 925-4031

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1770879694

Taxonomy: 261QD0000X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	32D2030128
LAB Type	Ambulatory Surgery Center
Facility Name	UNM DENTAL SERVICES CAMINO DE SALUD RESIDENCY CLINIC
Street	1801 CAMINO DE SALUD NE
City	ALBUQUERQUE
State	NM
ZIP	87102
Phone	505 925-4031
CertificateType	4
CertificateEffectiveDate	9/22/2023
CertificateExpirationDate	9/21/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024