32D2165093 CLIA NUMBER - COURAGEOUS TRANSFORMATION INC

Laboratory Demographics

CLIA Number: 32D2165093

Facility Name: COURAGEOUS TRANSFORMATION INC

Facility Address:
3223 LOS ARBOLES AVE NE
ALBUQUERQUE, NM
ZIP 87107
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Facility Phone Number: 505 800-7092

Facility Type: Physician Office

Certificate Type: Accreditation

NPI Number: 1568838795

Taxonomy: 261QM2800X - Clinic/Center
An entity, facility, or distinct part of a facility providing diagnostic, and replacement maintenance treatment services related to individuals with drug addiction.

CLIA Record

Field Name	Field Value
CLIA Number	32D2165093
LAB Type	Physician Office
Facility Name	COURAGEOUS TRANSFORMATION INC
Street	3223 LOS ARBOLES AVE NE
City	ALBUQUERQUE
State	NM
ZIP	87107
Phone	505 800-7092
CertificateType	1
CertificateEffectiveDate	12/18/2023
CertificateExpirationDate	12/17/2025
FacilityType	Accreditation

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This page was last updated on: 4/23/2024