45D0500630 CLIA NUMBER - TEXAS MEDCLINIC BL

Laboratory Demographics

  • CLIA Code: 45D0500630
  • Facility Name: TEXAS MEDCLINIC BL
  • Facility Address: 11811 BLANCO ROAD
    SAN ANTONIO, TX
    ZIP 78216
  • Facility Phone: 458 215-2457
  • Facility Type: Other - URGENT CARE
  • Facility Type: Microscopy
  • Lab Director: BRIAN RAIMONDO
  • NPI Number: 1003271800
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D0500630
LAB Type Other - URGENT CARE
Facility Name TEXAS MEDCLINIC BL
Street 11811 BLANCO ROAD
City SAN ANTONIO
State TX
ZIP 78216
Phone 458 215-2457
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 3/15/2024
Certificate Expiration Date 3/14/2026
Facility Type Other - URGENT CARE
Lab Director BRIAN RAIMONDO

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