45D0669172 CLIA NUMBER - DRS WAGNER AND WAGNER PA

Laboratory Demographics

  • CLIA Code: 45D0669172
  • Facility Name: DRS WAGNER AND WAGNER PA
  • Facility Address: 124 EAST WOLTERS AT 2ND STREET
    SHINER, TX
    ZIP 77984
  • Facility Phone: 361 594-3824
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: RALPH A. WAGNER, MD
  • NPI Number: 1124087887
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D0669172
LAB Type Physician Office
Facility Name DRS WAGNER AND WAGNER PA
Street 124 EAST WOLTERS AT 2ND STREET
City SHINER
State TX
ZIP 77984
Phone 361 594-3824
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 9/23/2025
Certificate Expiration Date 9/22/2027
Facility Type Physician Office
Lab Director RALPH A. WAGNER, MD

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