45D0992715 CLIA NUMBER - FOUR SEASONS OB GYN

Laboratory Demographics

CLIA Number: 45D0992715

Facility Name: FOUR SEASONS OB GYN

Facility Address:
7711 LOUIS PASTEUR DRIVE, SUITE 105
SAN ANTONIO, TX
ZIP 78229
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Facility Phone Number: 210 593-0700

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1316127111

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	45D0992715
LAB Type	Physician Office
Facility Name	FOUR SEASONS OB GYN
Street	7711 LOUIS PASTEUR DRIVE, SUITE 105
City	SAN ANTONIO
State	TX
ZIP	78229
Phone	210 593-0700
CertificateType	3
CertificateEffectiveDate	10/24/2023
CertificateExpirationDate	10/23/2025
FacilityType	PPMP

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This page was last updated on: 4/23/2024