32D2174479 CLIA NUMBER - LOTUS FAMILYHEALTH & WELLSNESS

Laboratory Demographics

CLIA Number: 32D2174479

Facility Name: LOTUS FAMILYHEALTH & WELLSNESS

Facility Address:
4504 4TH STREET NW
ALBUQUERQUE, NM
ZIP 87107
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Facility Phone Number: 505 896-1222

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1780059469

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	32D2174479
LAB Type	Physician Office
Facility Name	LOTUS FAMILYHEALTH & WELLSNESS
Street	4504 4TH STREET NW
City	ALBUQUERQUE
State	NM
ZIP	87107
Phone	505 896-1222
CertificateType	4
CertificateEffectiveDate	11/1/2023
CertificateExpirationDate	10/31/2025
FacilityType	Waiver

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