32D2301894 CLIA NUMBER - INNOVATION MEDICAL GROUP

Laboratory Demographics

  • CLIA Code: 32D2301894
  • Facility Name: INNOVATION MEDICAL GROUP
  • Facility Address: 4740 N BUTLER AVE
    FARMINGTON, NM
    ZIP 87401
  • Facility Phone: 801 266-3113
  • Facility Type: Ancillary Testing Site in Health Care Center
  • Facility Type: Waiver
  • Lab Director: KAREN TAPIA
  • NPI Number: 1629776893
  • Taxonomy: 213E00000X - Podiatrist

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CLIA Record

Field Name Field Value
CLIA Number 32D2301894
LAB Type Ancillary Testing Site in Health Care Center
Facility Name INNOVATION MEDICAL GROUP
Street 4740 N BUTLER AVE
City FARMINGTON
State NM
ZIP 87401
Phone 801 266-3113
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/2/2024
Certificate Expiration Date 4/1/2026
Facility Type Ancillary Testing Site in Health Care Center
Lab Director KAREN TAPIA

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