32D2055115 CLIA NUMBER - ASPEN MEDICAL GROUP LLC

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Laboratory Demographics

CLIA Number: 32D2055115

Facility Name: ASPEN MEDICAL GROUP LLC

Facility Address:
3450 ZAFARANO DRIVE SUITE C
SANTA FE, NM
ZIP 87507
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Facility Phone Number: 505 466-5885

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1396129581

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	32D2055115
LAB Type	Physician Office
Facility Name	ASPEN MEDICAL GROUP LLC
Street	3450 ZAFARANO DRIVE SUITE C
City	SANTA FE
State	NM
ZIP	87507
Phone	505 466-5885
CertificateType	3
CertificateEffectiveDate	3/6/2023
CertificateExpirationDate	3/5/2025
FacilityType	PPMP

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