32D2194318 CLIA NUMBER - BLC-PONCE DE LEON DBA BROOKDALE SANTA FE

Laboratory Demographics

  • CLIA Code: 32D2194318
  • Facility Name: BLC-PONCE DE LEON DBA BROOKDALE SANTA FE
  • Facility Address: 640 ALTA VISTA
    SANTA FE, NM
    ZIP 87505
  • Facility Phone: 505 984-8422
  • Facility Type: Assisted Living Facility
  • Facility Type: Waiver
  • Lab Director: PAMELA C. PLAZA
  • NPI Number: 1598565756
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 32D2194318
LAB Type Assisted Living Facility
Facility Name BLC-PONCE DE LEON DBA BROOKDALE SANTA FE
Street 640 ALTA VISTA
City SANTA FE
State NM
ZIP 87505
Phone 505 984-8422
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/30/2024
Certificate Expiration Date 9/29/2026
Facility Type Assisted Living Facility
Lab Director PAMELA C. PLAZA

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