32D2157149 CLIA NUMBER - JJDAC LLC DBA MED STAR AMBULANCE

Laboratory Demographics

  • CLIA Code: 32D2157149
  • Facility Name: JJDAC LLC DBA MED STAR AMBULANCE
  • Facility Address: 208 W MALONEY AVE
    GALLUP, NM
    ZIP 87301
  • Facility Phone: 505 722-5295
  • Facility Type: Ambulance
  • Facility Type: Waiver
  • Lab Director: DANNETTE LEGGITT
  • NPI Number: 1093883787
  • Taxonomy: 341600000X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 32D2157149
LAB Type Ambulance
Facility Name JJDAC LLC DBA MED STAR AMBULANCE
Street 208 W MALONEY AVE
City GALLUP
State NM
ZIP 87301
Phone 505 722-5295
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/31/2024
Certificate Expiration Date 10/30/2026
Facility Type Ambulance
Lab Director DANNETTE LEGGITT

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