32D2170837 CLIA NUMBER - SAN MIGUEL COUNTY DETENTION CENTER

Laboratory Demographics

  • CLIA Code: 32D2170837
  • Facility Name: SAN MIGUEL COUNTY DETENTION CENTER
  • Facility Address: 26 NM 283
    LAS VEGAS, NM
    ZIP 87701
  • Facility Phone: 505 587-6188
  • Facility Type: Other - COUNTY JAIL
  • Facility Type: Waiver
  • Lab Director: ROBERTA R. STUMBERG
  • NPI Number: 1114920717
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 32D2170837
LAB Type Other - COUNTY JAIL
Facility Name SAN MIGUEL COUNTY DETENTION CENTER
Street 26 NM 283
City LAS VEGAS
State NM
ZIP 87701
Phone 505 587-6188
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/20/2023
Certificate Expiration Date 8/19/2025
Facility Type Other - COUNTY JAIL
Lab Director ROBERTA R. STUMBERG

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