32D2305102 CLIA NUMBER - JICARILLA APACHE HEALTH & FITNESS CENTER

Laboratory Demographics

  • CLIA Code: 32D2305102
  • Facility Name: JICARILLA APACHE HEALTH & FITNESS CENTER
  • Facility Address: 80 NARROW GAUGE RD
    DULCE, NM
    ZIP 87528
  • Facility Phone: 575 759-3690
  • Facility Type: Other - COMMUNITY HEALTH
  • Facility Type: Waiver
  • Lab Director: SABRINA J. BACA
  • NPI Number: 1508051061
  • Taxonomy: 251S00000X - Community/Behavioral Health

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CLIA Record

Field Name Field Value
CLIA Number 32D2305102
LAB Type Other - COMMUNITY HEALTH
Facility Name JICARILLA APACHE HEALTH & FITNESS CENTER
Street 80 NARROW GAUGE RD
City DULCE
State NM
ZIP 87528
Phone 575 759-3690
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/24/2024
Certificate Expiration Date 5/23/2026
Facility Type Other - COMMUNITY HEALTH
Lab Director SABRINA J. BACA

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