45D0965918 CLIA NUMBER - SU CLINICA FAMILIAR SANTA ROSA

Laboratory Demographics

  • CLIA Code: 45D0965918
  • Facility Name: SU CLINICA FAMILIAR SANTA ROSA
  • Facility Address: HIGHWAY 107 LA FERIA AVE
    SANTA ROSA, TX
    ZIP 78593
  • Facility Phone: 956 365-6071
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: VALENTIN LOPEZ
  • NPI Number: 1386960862
  • Taxonomy: 261QF0400X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 45D0965918
LAB Type Community Clinic
Facility Name SU CLINICA FAMILIAR SANTA ROSA
Street HIGHWAY 107 LA FERIA AVE
City SANTA ROSA
State TX
ZIP 78593
Phone 956 365-6071
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/6/2025
Certificate Expiration Date 2/5/2027
Facility Type Community Clinic
Lab Director VALENTIN LOPEZ

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