32D2110182 CLIA NUMBER - SOUTHWEST PEDIATRIC CARE LLC

Laboratory Demographics

  • CLIA Code: 32D2110182
  • Facility Name: SOUTHWEST PEDIATRIC CARE LLC
  • Facility Address: 1020 S 8TH STREET, SUITE A
    DEMING, NM
    ZIP 88030
  • Facility Phone: 575 936-4350
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: JOEL ROQUE
  • NPI Number: 1881089886
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 32D2110182
LAB Type Practitioner Other
Facility Name SOUTHWEST PEDIATRIC CARE LLC
Street 1020 S 8TH STREET, SUITE A
City DEMING
State NM
ZIP 88030
Phone 575 936-4350
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/10/2024
Certificate Expiration Date 3/9/2026
Facility Type Practitioner Other
Lab Director JOEL ROQUE

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This page was last updated on: 6/4/2025