32D2319585 CLIA NUMBER - GRAND SUMMIT

Laboratory Demographics

  • CLIA Code: 32D2319585
  • Facility Name: GRAND SUMMIT
  • Facility Address: 13207 CENTRAL AVE NE
    ALBUQUERQUE, NM
    ZIP 87123
  • Facility Phone: 505 274-3556
  • Facility Type: Comp. Outpatient Rehab Facility
  • Facility Type: Waiver
  • Lab Director: DAVID CURTIS JOHNSON
  • NPI Number: 1982420329
  • Taxonomy: 261QM2800X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 32D2319585
LAB Type Comp. Outpatient Rehab Facility
Facility Name GRAND SUMMIT
Street 13207 CENTRAL AVE NE
City ALBUQUERQUE
State NM
ZIP 87123
Phone 505 274-3556
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/4/2025
Certificate Expiration Date 3/3/2027
Facility Type Comp. Outpatient Rehab Facility
Lab Director DAVID CURTIS JOHNSON

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