45D0983118 CLIA NUMBER - MISSION ROAD DEVELOPMENTAL CENTER

Laboratory Demographics

  • CLIA Code: 45D0983118
  • Facility Name: MISSION ROAD DEVELOPMENTAL CENTER
  • Facility Address: 8706 MISSION ROAD
    SAN ANTONIO, TX
    ZIP 78214
  • Facility Phone: 210 924-9265
  • Facility Type: Intermediate Care Facility for Mentally Retarded
  • Facility Type: Waiver
  • Lab Director: PATRICIA L. HANSON
  • NPI Number: 1538532429
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 45D0983118
LAB Type Intermediate Care Facility for Mentally Retarded
Facility Name MISSION ROAD DEVELOPMENTAL CENTER
Street 8706 MISSION ROAD
City SAN ANTONIO
State TX
ZIP 78214
Phone 210 924-9265
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/14/2025
Certificate Expiration Date 2/13/2027
Facility Type Intermediate Care Facility for Mentally Retarded
Lab Director PATRICIA L. HANSON

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