32D2199718 CLIA NUMBER - STATE OF THE HEART RECOVERY INC

Home > CLIA Lookup > 32D2199718

Laboratory Demographics

CLIA Number: 32D2199718

Facility Name: STATE OF THE HEART RECOVERY INC

Facility Address:
203 CALIFORNIA ST NE
ALBUQUERQUE, NM
ZIP 87108
Get Directions

Facility Phone Number: 505 308-8296

Facility Type: Community Clinic

Certificate Type: Waiver

NPI Number: 1700407277

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	32D2199718
LAB Type	Community Clinic
Facility Name	STATE OF THE HEART RECOVERY INC
Street	203 CALIFORNIA ST NE
City	ALBUQUERQUE
State	NM
ZIP	87108
Phone	505 308-8296
CertificateType	4
CertificateEffectiveDate	11/10/2022
CertificateExpirationDate	11/9/2024
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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