32D2305981 CLIA NUMBER - OLIVE TREE COMPOUNDING PHARMACY

Laboratory Demographics

  • CLIA Code: 32D2305981
  • Facility Name: OLIVE TREE COMPOUNDING PHARMACY
  • Facility Address: 1713 WELLSPRING AVENUE SE STE A
    RIO RANCHO, NM
    ZIP 87124
  • Facility Phone: 505 738-3328
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NDIDIAMAKA OKPAREKE
  • NPI Number: 1588402580
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 32D2305981
LAB Type Pharmacy
Facility Name OLIVE TREE COMPOUNDING PHARMACY
Street 1713 WELLSPRING AVENUE SE STE A
City RIO RANCHO
State NM
ZIP 87124
Phone 505 738-3328
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/10/2024
Certificate Expiration Date 6/9/2026
Facility Type Pharmacy
Lab Director NDIDIAMAKA OKPAREKE

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