32D2230161 CLIA NUMBER - VICTOR'S REGENT PHARMACY

Laboratory Demographics

  • CLIA Code: 32D2230161
  • Facility Name: VICTOR'S REGENT PHARMACY
  • Facility Address: 1643 ISLETA BLVD SW
    ALBUQUERQUE, NM
    ZIP 87105
  • Facility Phone: 505 877-1620
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TERI M. ROLAN
  • NPI Number: 1942242516
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 32D2230161
LAB Type Pharmacy
Facility Name VICTOR'S REGENT PHARMACY
Street 1643 ISLETA BLVD SW
City ALBUQUERQUE
State NM
ZIP 87105
Phone 505 877-1620
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/20/2025
Certificate Expiration Date 7/19/2027
Facility Type Pharmacy
Lab Director TERI M. ROLAN

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