32D2188385 CLIA NUMBER - FOS WELLNESS

Laboratory Demographics

  • CLIA Code: 32D2188385
  • Facility Name: FOS WELLNESS
  • Facility Address: 1698 S ROOSEVELT ROAD 13
    PORTALES, NM
    ZIP 88130
  • Facility Phone: 575 607-8702
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: REBECCA K. KIZER
  • NPI Number: 1982185948
  • Taxonomy: 363LF0000X - Nurse Practitioner

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 32D2188385
LAB Type Mobile Laboratory
Facility Name FOS WELLNESS
Street 1698 S ROOSEVELT ROAD 13
City PORTALES
State NM
ZIP 88130
Phone 575 607-8702
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/16/2024
Certificate Expiration Date 7/15/2026
Facility Type Mobile Laboratory
Lab Director REBECCA K. KIZER

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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