45D0710284 CLIA NUMBER - ANDRES BONELLI MD

Laboratory Demographics

CLIA Number: 45D0710284

Facility Name: ANDRES BONELLI MD

Facility Address:
1521 SOUTH STAPLES, SUITE 403
CORPUS CHRISTI, TX
ZIP 78404
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Facility Phone Number: 361 882-1917

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1245225663

Taxonomy: 207RG0300X - Internal Medicine
An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital.

CLIA Record

Field Name	Field Value
CLIA Number	45D0710284
LAB Type	Physician Office
Facility Name	ANDRES BONELLI MD
Street	1521 SOUTH STAPLES, SUITE 403
City	CORPUS CHRISTI
State	TX
ZIP	78404
Phone	361 882-1917
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024