45D0984668 CLIA NUMBER - IRC-SAN ANTONIO-MEDICAL DRIVE

Laboratory Demographics

  • CLIA Code: 45D0984668
  • Facility Name: IRC-SAN ANTONIO-MEDICAL DRIVE
  • Facility Address: 3939 MEDICAL DRIVE, # 110
    SAN ANTONIO, TX
    ZIP 78229
  • Facility Phone: 210 692-3075
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: OSCAR IZNAOLA-ESQUIVEL
  • NPI Number: 1376138479
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D0984668
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name IRC-SAN ANTONIO-MEDICAL DRIVE
Street 3939 MEDICAL DRIVE, # 110
City SAN ANTONIO
State TX
ZIP 78229
Phone 210 692-3075
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/27/2025
Certificate Expiration Date 3/26/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director OSCAR IZNAOLA-ESQUIVEL

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