32D2325451 CLIA NUMBER - HEALTHY YOU PERSONALIZED PRIMARY CARE

Laboratory Demographics

  • CLIA Code: 32D2325451
  • Facility Name: HEALTHY YOU PERSONALIZED PRIMARY CARE
  • Facility Address: 1240 S TELSHOR BLVD STE A
    LAS CRUCES, NM
    ZIP 88011
  • Facility Phone: 575 915-8821
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: AMANDA B. PROVENCIO
  • NPI Number: 1780473785
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 32D2325451
LAB Type Physician Office
Facility Name HEALTHY YOU PERSONALIZED PRIMARY CARE
Street 1240 S TELSHOR BLVD STE A
City LAS CRUCES
State NM
ZIP 88011
Phone 575 915-8821
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/12/2025
Certificate Expiration Date 6/11/2027
Facility Type Physician Office
Lab Director AMANDA B. PROVENCIO

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