45D0962394 CLIA NUMBER - CHILD STUDY CLINIC

Laboratory Demographics

  • CLIA Code: 45D0962394
  • Facility Name: CHILD STUDY CLINIC
  • Facility Address: 4208 RETAMA CIRCLE
    VICTORIA, TX
    ZIP 77904
  • Facility Phone: 361 575-0681
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARISOL ORTIZ
  • NPI Number: 1396869780
  • Taxonomy: 171M00000X - Case Manager/Care Coordinator

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 45D0962394
LAB Type Physician Office
Facility Name CHILD STUDY CLINIC
Street 4208 RETAMA CIRCLE
City VICTORIA
State TX
ZIP 77904
Phone 361 575-0681
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/2/2025
Certificate Expiration Date 7/1/2027
Facility Type Physician Office
Lab Director MARISOL ORTIZ

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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