32D2269385 CLIA NUMBER - ROADRUNNER HEALTH SERVICES, LLC MCKINLEY COUNTY DETENTION CENTER

Laboratory Demographics

  • CLIA Code: 32D2269385
  • Facility Name: ROADRUNNER HEALTH SERVICES, LLC MCKINLEY COUNTY DETENTION CENTER
  • Facility Address: 225 BOARDMAN S BOARDMAN DR
    GALLUP, NM
    ZIP 87301
  • Facility Phone: (505) 366-1184
  • Facility Type: Other - COUNTY DETENTION CENTER
  • Facility Type: Waiver
  • Lab Director: DR. LEVI MAES
  • NPI Number: 1811873813
  • Taxonomy: 261QP2400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 32D2269385
LAB Type Other - COUNTY DETENTION CENTER
Facility Name ROADRUNNER HEALTH SERVICES, LLC MCKINLEY COUNTY DETENTION CENTER
Street 225 BOARDMAN S BOARDMAN DR
City GALLUP
State NM
ZIP 87301
Phone 5053661184
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/26/2024
Certificate Expiration Date 9/25/2026
Facility Type Other - COUNTY DETENTION CENTER
Lab Director DR. LEVI MAES

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This page was last updated on: 5/18/2026