45D0501119 CLIA NUMBER - GENESIS

Laboratory Demographics

  • CLIA Code: 45D0501119
  • Facility Name: GENESIS
  • Facility Address: 9647 HUEBNER RD
    SAN ANTONIO, TX
    ZIP 78240
  • Facility Phone: 210 735-5225
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JUANITA SPRUTE
  • NPI Number: 1417991035
  • Taxonomy: 261QH0100X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D0501119
LAB Type Physician Office
Facility Name GENESIS
Street 9647 HUEBNER RD
City SAN ANTONIO
State TX
ZIP 78240
Phone 210 735-5225
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 12/19/2024
Certificate Expiration Date 12/18/2026
Facility Type Physician Office
Lab Director JUANITA SPRUTE

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