45D2077590 CLIA NUMBER - INTELLIMEDICINE,PA

Laboratory Demographics

  • CLIA Code: 45D2077590
  • Facility Name: INTELLIMEDICINE,PA
  • Facility Address: 154 NORTH FESTIVAL DRIVE VILLA F
    EL PASO, TX
    ZIP 79912
  • Facility Phone: (915) 532-5858
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: ROXANNE TYROCH
  • NPI Number: 1134545924
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D2077590
LAB Type Physician Office
Facility Name INTELLIMEDICINE,PA
Street 154 NORTH FESTIVAL DRIVE VILLA F
City EL PASO
State TX
ZIP 79912
Phone 9155325858
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 5/12/2026
Certificate Expiration Date 5/11/2028
Facility Type Physician Office
Lab Director ROXANNE TYROCH

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This page was last updated on: 5/15/2026