45D0907088 CLIA NUMBER - THOMAS H RAETZSCH

Laboratory Demographics

CLIA Number: 45D0907088

Facility Name: THOMAS H RAETZSCH

Facility Address:
1025 N AUSTIN
SEGUIN, TX
ZIP 78155
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Facility Phone Number: 830 379-1184

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1639631666

Taxonomy: 390200000X - Student in an Organized Health Care Education/Training Program
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

CLIA Record

Field Name	Field Value
CLIA Number	45D0907088
LAB Type	Physician Office
Facility Name	THOMAS H RAETZSCH
Street	1025 N AUSTIN
City	SEGUIN
State	TX
ZIP	78155
Phone	830 379-1184
CertificateType	4
CertificateEffectiveDate	10/9/2023
CertificateExpirationDate	10/8/2025
FacilityType	Waiver

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