45D0939396 CLIA NUMBER - SAN ANTONIO PREVENTIVE & DIAGNOSTIC MED

Laboratory Demographics

  • CLIA Code: 45D0939396
  • Facility Name: SAN ANTONIO PREVENTIVE & DIAGNOSTIC MED
  • Facility Address: 2829 BOBCOCK RD, SUITE 500
    SAN ANTONIO, TX
    ZIP 78229
  • Facility Phone: 210 949-2200
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: THOMAS MIERAS
  • NPI Number: 1417951237
  • Taxonomy: 335E00000X - Prosthetic/Orthotic Supplier

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CLIA Record

Field Name Field Value
CLIA Number 45D0939396
LAB Type Physician Office
Facility Name SAN ANTONIO PREVENTIVE & DIAGNOSTIC MED
Street 2829 BOBCOCK RD, SUITE 500
City SAN ANTONIO
State TX
ZIP 78229
Phone 210 949-2200
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/3/2024
Certificate Expiration Date 1/2/2026
Facility Type Physician Office
Lab Director THOMAS MIERAS

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