32D2200853 CLIA NUMBER - RMCHCS MOBILE CLINIC

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Laboratory Demographics

CLIA Number: 32D2200853

Facility Name: RMCHCS MOBILE CLINIC

Facility Address:
2111 COLLEGE DRIVE
GALLUP, NM
ZIP 87301
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Facility Phone Number: 505 863-7000

Facility Type: Mobile Laboratory

Certificate Type: Waiver

NPI Number: 1164572533

Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

CLIA Record

Field Name	Field Value
CLIA Number	32D2200853
LAB Type	Mobile Laboratory
Facility Name	RMCHCS MOBILE CLINIC
Street	2111 COLLEGE DRIVE
City	GALLUP
State	NM
ZIP	87301
Phone	505 863-7000
CertificateType	4
CertificateEffectiveDate	11/17/2022
CertificateExpirationDate	11/16/2024
FacilityType	Waiver

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