32D2277060 CLIA NUMBER - DANIEL FENTON FNP

Laboratory Demographics

  • CLIA Code: 32D2277060
  • Facility Name: DANIEL FENTON FNP
  • Facility Address: 801 E ROOSEVELT ST
    GRANTS, NM
    ZIP 87020
  • Facility Phone: 505 658-1347
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DANIEL E. FENTON
  • NPI Number: 1093283863
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 32D2277060
LAB Type Physician Office
Facility Name DANIEL FENTON FNP
Street 801 E ROOSEVELT ST
City GRANTS
State NM
ZIP 87020
Phone 505 658-1347
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/21/2025
Certificate Expiration Date 2/20/2027
Facility Type Physician Office
Lab Director DANIEL E. FENTON

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