45D1015991 CLIA NUMBER - SUBRA ANANDASIVAM M D P A

Laboratory Demographics

  • CLIA Code: 45D1015991
  • Facility Name: SUBRA ANANDASIVAM M D P A
  • Facility Address: 64 S PRICE ROAD SUITE A
    BROWNSVILLE, TX
    ZIP 78521
  • Facility Phone: 956 548-2242
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LOGA ANANDASIVAM
  • NPI Number: 1669611596
  • Taxonomy: 207RN0300X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D1015991
LAB Type Physician Office
Facility Name SUBRA ANANDASIVAM M D P A
Street 64 S PRICE ROAD SUITE A
City BROWNSVILLE
State TX
ZIP 78521
Phone 956 548-2242
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/18/2025
Certificate Expiration Date 8/17/2027
Facility Type Physician Office
Lab Director LOGA ANANDASIVAM

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