32D2291916 CLIA NUMBER - PEDS TOTS TO TEENS

Laboratory Demographics

  • CLIA Code: 32D2291916
  • Facility Name: PEDS TOTS TO TEENS
  • Facility Address: 1180 MALL DRIVE, STE B
    LAS CRUCES, NM
    ZIP 88011
  • Facility Phone: 575 386-6876
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: USHA PHILLIPS
  • NPI Number: 1245920396
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 32D2291916
LAB Type Physician Office
Facility Name PEDS TOTS TO TEENS
Street 1180 MALL DRIVE, STE B
City LAS CRUCES
State NM
ZIP 88011
Phone 575 386-6876
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/18/2023
Certificate Expiration Date 10/17/2025
Facility Type Physician Office
Lab Director USHA PHILLIPS

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