45D1092128 CLIA NUMBER - SIERRA PROVIDENCE MEDICAL PARTNERS - SIERRA CAMPUS

Laboratory Demographics

  • CLIA Code: 45D1092128
  • Facility Name: SIERRA PROVIDENCE MEDICAL PARTNERS - SIERRA CAMPUS
  • Facility Address: 1600 MEDICAL CENTER DRIVE SUITE 405
    EL PASO, TX
    ZIP 79902
  • Facility Phone: 915 533-6690
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: CHIOMA M. MGBOKWERE
  • NPI Number: 1447275664
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 45D1092128
LAB Type Physician Office
Facility Name SIERRA PROVIDENCE MEDICAL PARTNERS - SIERRA CAMPUS
Street 1600 MEDICAL CENTER DRIVE SUITE 405
City EL PASO
State TX
ZIP 79902
Phone 915 533-6690
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 11/18/2024
Certificate Expiration Date 11/17/2026
Facility Type Physician Office
Lab Director CHIOMA M. MGBOKWERE

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This page was last updated on: 3/20/2025