32D2139093 CLIA NUMBER - INTEGRATED HEALTHCARE LLC

Laboratory Demographics

  • CLIA Code: 32D2139093
  • Facility Name: INTEGRATED HEALTHCARE LLC
  • Facility Address: 4011 BARBARA LOOP SUITE 203
    RIO RANCHO, NM
    ZIP 87124
  • Facility Phone: 505 994-4503
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: JACQUELINE E. WILLIS
  • NPI Number: 1659800894
  • Taxonomy: 363LP0808X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 32D2139093
LAB Type Practitioner Other
Facility Name INTEGRATED HEALTHCARE LLC
Street 4011 BARBARA LOOP SUITE 203
City RIO RANCHO
State NM
ZIP 87124
Phone 505 994-4503
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/30/2023
Certificate Expiration Date 10/29/2025
Facility Type Practitioner Other
Lab Director JACQUELINE E. WILLIS

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