32D2283387 CLIA NUMBER - JOURNEY PEDIATRICS PC

Laboratory Demographics

CLIA Number: 32D2283387

Facility Name: JOURNEY PEDIATRICS PC

Facility Address:
2411 CABEZON BLVD SE SUITE B
RIO RANCHO, NM
ZIP 87124
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Facility Phone Number: 505 883-9570

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1205205630

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	32D2283387
LAB Type	Physician Office
Facility Name	JOURNEY PEDIATRICS PC
Street	2411 CABEZON BLVD SE SUITE B
City	RIO RANCHO
State	NM
ZIP	87124
Phone	505 883-9570
CertificateType	4
CertificateEffectiveDate	6/7/2023
CertificateExpirationDate	6/6/2025
FacilityType	Waiver

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