45D1058641 CLIA NUMBER - TEXAS MEDCLINIC - LS

Laboratory Demographics

  • CLIA Code: 45D1058641
  • Facility Name: TEXAS MEDCLINIC - LS
  • Facility Address: 23611 IH 10 WEST
    SAN ANTONIO, TX
    ZIP 78257
  • Facility Phone: 541 641-6053
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JEFFREY WEAVER
  • NPI Number: 1114382918
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D1058641
LAB Type Physician Office
Facility Name TEXAS MEDCLINIC - LS
Street 23611 IH 10 WEST
City SAN ANTONIO
State TX
ZIP 78257
Phone 541 641-6053
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/12/2024
Certificate Expiration Date 9/11/2026
Facility Type Physician Office
Lab Director JEFFREY WEAVER

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