45D1071553 CLIA NUMBER - HEB PHARMACY 164

Laboratory Demographics

  • CLIA Code: 45D1071553
  • Facility Name: HEB PHARMACY 164
  • Facility Address: 15000 SAN PEDRO
    SAN ANTONIO, TX
    ZIP 78232
  • Facility Phone: 210 494-3203
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ERNEST MEDINA
  • NPI Number: 1487763819
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D1071553
LAB Type Pharmacy
Facility Name HEB PHARMACY 164
Street 15000 SAN PEDRO
City SAN ANTONIO
State TX
ZIP 78232
Phone 210 494-3203
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/27/2025
Certificate Expiration Date 7/26/2027
Facility Type Pharmacy
Lab Director ERNEST MEDINA

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