Organization Active NPI

Southwest Labs LLC

  • Clinical Medical Laboratory
  • Albuquerque, NM
National Provider Identifier
1780059717
Registry record updated Jun 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
SOUTHWEST LABS LLC
Practice address
4261 Balloon Park Rd NE
Albuquerque, NM 87109-5802
Phone
(505) 433-3985
NPI assigned
Dec 2, 2015
Last updated
Jun 15, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Evan D Baldwin, MDNPI 1730470113
Title
Partner / Medical Director
Phone
(505) 433-3985

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X NU Primary

Addresses

Primary practice location

4261 Balloon Park Rd NE
Albuquerque, NM 87109-5802

Mailing address

4261 Balloon Park Rd NE
Albuquerque, NM 87109-5802

Other practice location 1

4343 Pan American Fwy NE Ste 238
Albuquerque, NM 87107-6834
Phone (505) 609-5227

Other identifiers 1

IdentifierTypeStateIssuer
61330086MedicaidNM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160628001489 NM Part B Supplier - Independent Clinical Laboratory 2961793658 Practice locations: Albuquerque, NM

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
32D2110679Southwest Labs, LLC4261 Balloon Park Road NE, Albuquerque, NM 87109AccreditationDec 6, 2026
32D2339883Southwest Labs LLC4343 Pan American Fwy NE, #238, Albuquerque, NM 87107RegistrationMar 8, 2028

National Provider Directory

National Provider Directory

Locations

4261 Balloon Park Rd NE
Albuquerque, NM 87109
Phone (505) 433-3985

4500 Osuna Rd NE
Ste 130
Albuquerque, NM 87109
Phone (505) 565-5282

5659 Jefferson St NE
Ste D
Albuquerque, NM 87109
Phone (505) 433-3985

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1449014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781481600000",
    "number": "1780059717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4261 BALLOON PARK RD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871095802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4261 BALLOON PARK RD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871095802",
            "telephone_number": "505-433-3985"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4343 Pan American Fwy NE Ste 238",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "871076834",
            "country_code": "US",
            "telephone_number": "505-609-5227",
            "fax_number": "505-508-5512",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUTHWEST LABS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-02",
        "last_updated": "2026-06-15",
        "certification_date": "2026-06-15",
        "status": "A",
        "authorized_official_last_name": "BALDWIN",
        "authorized_official_first_name": "EVAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PARTNER / MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "505-433-3985",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "61330086",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.