32D2298405 CLIA NUMBER - VANGUARD BEHAVIORAL NM LLC

Laboratory Demographics

  • CLIA Code: 32D2298405
  • Facility Name: VANGUARD BEHAVIORAL NM LLC
  • Facility Address: 6809 KENTUCKY CT NE
    ALBUQUERQUE, NM
    ZIP 87110
  • Facility Phone: 480 320-0752
  • Facility Type: Other - SUBSTANCE USE TREATMENT C
  • Facility Type: Waiver
  • Lab Director: MARK GOULD
  • NPI Number: 1417695149
  • Taxonomy: 261QR0405X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 32D2298405
LAB Type Other - SUBSTANCE USE TREATMENT C
Facility Name VANGUARD BEHAVIORAL NM LLC
Street 6809 KENTUCKY CT NE
City ALBUQUERQUE
State NM
ZIP 87110
Phone 480 320-0752
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/1/2024
Certificate Expiration Date 1/31/2026
Facility Type Other - SUBSTANCE USE TREATMENT C
Lab Director MARK GOULD

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