32D2283144 CLIA NUMBER - INTEGRATIVE & PERSONALIZED HORMONE THERAPY

Laboratory Demographics

  • CLIA Code: 32D2283144
  • Facility Name: INTEGRATIVE & PERSONALIZED HORMONE THERAPY
  • Facility Address: 1245 COUNTRY CLUB RD STE 200
    SANTA TERESA, NM
    ZIP 88008
  • Facility Phone: 575 332-4633
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: CHRISTINA BLANCO
  • NPI Number: 1346784287
  • Taxonomy: 363LW0102X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 32D2283144
LAB Type Practitioner Other
Facility Name INTEGRATIVE & PERSONALIZED HORMONE THERAPY
Street 1245 COUNTRY CLUB RD STE 200
City SANTA TERESA
State NM
ZIP 88008
Phone 575 332-4633
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/1/2025
Certificate Expiration Date 5/31/2027
Facility Type Practitioner Other
Lab Director CHRISTINA BLANCO

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