32D2094253 CLIA NUMBER - RECOVERY SERVICES OF NEW MEXICO MDC

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Laboratory Demographics

CLIA Number: 32D2094253

Facility Name: RECOVERY SERVICES OF NEW MEXICO MDC

Facility Address:
DETENTION CENTER UNIT FC-174 100 DEPUTY DEAN MIERA DR SW
ALBUQUERQUE, NM
ZIP 87151
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Facility Phone Number: 505 839-8700

Facility Type: Other - TREATMENT PROGRAM

Certificate Type: Waiver

NPI Number: 1598015356

Taxonomy: 261QM2800X - Clinic/Center
An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction.

CLIA Record

Field Name	Field Value
CLIA Number	32D2094253
LAB Type	Other - TREATMENT PROGRAM
Facility Name	RECOVERY SERVICES OF NEW MEXICO MDC
Street	DETENTION CENTER UNIT FC-174 100 DEPUTY DEAN MIERA DR SW
City	ALBUQUERQUE
State	NM
ZIP	87151
Phone	505 839-8700
CertificateType	4
CertificateEffectiveDate	4/14/2023
CertificateExpirationDate	4/13/2025
FacilityType	Waiver

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