32D2235893 CLIA NUMBER - NMCW

Laboratory Demographics

CLIA Number: 32D2235893

Facility Name: NMCW

Facility Address:
1580 APPALOOSA DR SUITE 30
SUNLAND PARK, NM
ZIP 88063
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Facility Phone Number: 915 873-0603

Facility Type: Mobile Laboratory

Certificate Type: Waiver

NPI Number: 1740956861

Taxonomy: 363LF0000X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	32D2235893
LAB Type	Mobile Laboratory
Facility Name	NMCW
Street	1580 APPALOOSA DR SUITE 30
City	SUNLAND PARK
State	NM
ZIP	88063
Phone	915 873-0603
CertificateType	4
CertificateEffectiveDate	9/13/2023
CertificateExpirationDate	9/12/2025
FacilityType	Waiver

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