45D0973607 CLIA NUMBER - VMD PRIMARY PROVIDERS OF SOUTH HILL COUNTRY TX HELOTES

Laboratory Demographics

  • CLIA Code: 45D0973607
  • Facility Name: VMD PRIMARY PROVIDERS OF SOUTH HILL COUNTRY TX HELOTES
  • Facility Address: 12952 BANDERA ROAD, SUITE 105
    HELOTES, TX
    ZIP 78023
  • Facility Phone: 210 695-1900
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ROSEN TRINIDAD
  • NPI Number: 1083640320
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 45D0973607
LAB Type Physician Office
Facility Name VMD PRIMARY PROVIDERS OF SOUTH HILL COUNTRY TX HELOTES
Street 12952 BANDERA ROAD, SUITE 105
City HELOTES
State TX
ZIP 78023
Phone 210 695-1900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/29/2024
Certificate Expiration Date 1/28/2026
Facility Type Physician Office
Lab Director ROSEN TRINIDAD

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