45D1071575 CLIA NUMBER - HEB PHARMACY 191

Laboratory Demographics

  • CLIA Code: 45D1071575
  • Facility Name: HEB PHARMACY 191
  • Facility Address: 4821 BROADWAY
    SAN ANTONIO, TX
    ZIP 78209
  • Facility Phone: 210 824-0515
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: THERESA CASTILLO
  • NPI Number: 1790894764
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D1071575
LAB Type Pharmacy
Facility Name HEB PHARMACY 191
Street 4821 BROADWAY
City SAN ANTONIO
State TX
ZIP 78209
Phone 210 824-0515
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/30/2025
Certificate Expiration Date 7/29/2027
Facility Type Pharmacy
Lab Director THERESA CASTILLO

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