45D1011974 CLIA NUMBER - THOUSAND OAKS PEDIATRIC CENTER

Laboratory Demographics

  • CLIA Code: 45D1011974
  • Facility Name: THOUSAND OAKS PEDIATRIC CENTER
  • Facility Address: 4360 THOUSAND OAKS
    SAN ANTONIO, TX
    ZIP 78217
  • Facility Phone: (210) 887-1958
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MAGED M. GEORGE
  • NPI Number: 1508691411
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 45D1011974
LAB Type Physician Office
Facility Name THOUSAND OAKS PEDIATRIC CENTER
Street 4360 THOUSAND OAKS
City SAN ANTONIO
State TX
ZIP 78217
Phone 2108871958
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/29/2025
Certificate Expiration Date 4/28/2027
Facility Type Physician Office
Lab Director MAGED M. GEORGE

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This page was last updated on: 5/18/2026