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EDGEWOOD PEDIATRIC CLINIC L.L.C.
NPI 1699905927
Pediatrics in Edgewood, NM

Active since July 21, 2009CLIA 32D1103934 · Waiver
2 EUNICE CT BLDG B, EDGEWOOD, NM 87015(505) 281-4620(505) 281-0397 Get Directions Write a Review

NPPES record last updated: May 30, 2012. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Edgewood Pediatric Clinic L.l.c. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EDGEWOOD PEDIATRIC CLINIC L.L.C. (NPI 1699905927) is a healthcare organization registered as a pediatrics in Edgewood, New Mexico and active in the NPI registry since July 2009. The organization holds a CLIA Waiver certificate valid through August 20, 2027 and lists Sharon Diane Garnand, Owner, as its authorized official.

NPPES Registry Identity

NPI1699905927
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameEDGEWOOD PEDIATRIC CLINIC L.L.C.
Location Address2 EUNICE CT BLDG BEdgewood, NM 87015-9108
Mailing AddressPo Box 1320Edgewood, NM 87015-1320 · (505) 281-4620 · Fax (505) 281-0397
Phone(505) 281-4620
Fax(505) 281-0397
Organization SubpartNo
Authorized OfficialSharon Diane GarnandOwner · (505) 281-4620
Enumeration DateJuly 21, 2009
Last NPPES UpdateMay 30, 2012
✔ NPI 1699905927 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in NM · 2003-0092
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
2 EUNICE CT BLDG B, Edgewood, NM 87015
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 32D1103934

Edgewood Pediatric Clinic · Edgewood, NM
Active · expires Aug 20, 2027
CLIA Number32D1103934
Laboratory TypePhysician Office
Certificate Effective DateAugust 21, 2025
Certificate Expiration DateAugust 20, 2027
Laboratory DirectorSharon D. Garnard M D
Laboratory Phone(505) 281-4620
Laboratory LocationEdgewood Pediatric Clinic02 Eunice Court Building B, Edgewood, NM 87015
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Edgewood Pediatric Clinic L.L.C.'s NPI number?

The NPI number for Edgewood Pediatric Clinic L.L.C. is 1699905927. It was assigned to this organization in the NPPES registry on July 21, 2009.

Where is Edgewood Pediatric Clinic L.L.C. located?

Edgewood Pediatric Clinic L.L.C. is located at 2 Eunice Ct Bldg B, Edgewood, NM 87015. The listed phone number is (505) 281-4620.

What is Edgewood Pediatric Clinic L.L.C.'s specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does Edgewood Pediatric Clinic L.L.C. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 32D1103934) is associated with this NPI, valid through August 20, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Edgewood Pediatric Clinic L.L.C. was last updated on May 30, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.