45D0965745 CLIA NUMBER - CENTRO SAN VICENTE

Laboratory Demographics

  • CLIA Code: 45D0965745
  • Facility Name: CENTRO SAN VICENTE
  • Facility Address: 13017 PERICO
    SAN ELIZARIO, TX
    ZIP 79849
  • Facility Phone: (915) 851-0999
  • Facility Type: Community Clinic
  • Facility Type: Microscopy
  • Lab Director: JOSE LUNA JR MD
  • NPI Number: 1780761452
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D0965745
LAB Type Community Clinic
Facility Name CENTRO SAN VICENTE
Street 13017 PERICO
City SAN ELIZARIO
State TX
ZIP 79849
Phone 9158510999
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 7/10/2024
Certificate Expiration Date 7/9/2026
Facility Type Community Clinic
Lab Director JOSE LUNA JR MD

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This page was last updated on: 6/29/2026