45D0679892 CLIA NUMBER - PM MANAGEMENT - BABCOCK NC, LLC D/B/A/ MESA VISTA INN HEALTH CENTER

Laboratory Demographics

  • CLIA Code: 45D0679892
  • Facility Name: PM MANAGEMENT - BABCOCK NC, LLC D/B/A/ MESA VISTA INN HEALTH CENTER
  • Facility Address: 5756 N KNOLL DRIVE
    SAN ANTONIO, TX
    ZIP 78240
  • Facility Phone: 210 341-8681
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: CHARLES S. MOODY
  • NPI Number: 1033279930
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 45D0679892
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name PM MANAGEMENT - BABCOCK NC, LLC D/B/A/ MESA VISTA INN HEALTH CENTER
Street 5756 N KNOLL DRIVE
City SAN ANTONIO
State TX
ZIP 78240
Phone 210 341-8681
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director CHARLES S. MOODY

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