32D2139044 CLIA NUMBER - ROSWELL CLINIC CORP DBA PONDEROSA MEDICAL ASSOCIATES

Laboratory Demographics

  • CLIA Code: 32D2139044
  • Facility Name: ROSWELL CLINIC CORP DBA PONDEROSA MEDICAL ASSOCIATES
  • Facility Address: 300 W COUNTRY CLUB RD, SUITE 230
    ROSWELL, NM
    ZIP 88201
  • Facility Phone: 575 622-1411
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. RICHARD PINON
  • NPI Number: 1417656869
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 32D2139044
LAB Type Physician Office
Facility Name ROSWELL CLINIC CORP DBA PONDEROSA MEDICAL ASSOCIATES
Street 300 W COUNTRY CLUB RD, SUITE 230
City ROSWELL
State NM
ZIP 88201
Phone 575 622-1411
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 10/30/2023
Certificate Expiration Date 10/29/2025
Facility Type Physician Office
Lab Director DR. RICHARD PINON

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This page was last updated on: 9/29/2025