32D2104909 CLIA NUMBER - FLT LLC

Laboratory Demographics

  • CLIA Code: 32D2104909
  • Facility Name: FLT LLC
  • Facility Address: 607 W COUNTRY CLUB ROAD
    ROSWELL, NM
    ZIP 88201
  • Facility Phone: 575 208-7795
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DAWN C. WULF
  • NPI Number: 1366810970
  • Taxonomy: 363LF0000X - Nurse Practitioner

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 32D2104909
LAB Type Physician Office
Facility Name FLT LLC
Street 607 W COUNTRY CLUB ROAD
City ROSWELL
State NM
ZIP 88201
Phone 575 208-7795
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/16/2023
Certificate Expiration Date 11/15/2025
Facility Type Physician Office
Lab Director DAWN C. WULF

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

This page was last updated on: 3/20/2025