45D1071594 CLIA NUMBER - HEB PHARMACY 384

Laboratory Demographics

  • CLIA Code: 45D1071594
  • Facility Name: HEB PHARMACY 384
  • Facility Address: 6030 MONTGOMERY ROAD
    SAN ANTONIO, TX
    ZIP 78239
  • Facility Phone: 210 938-2384
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LESLIE CASTILLO
  • NPI Number: 1750490181
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D1071594
LAB Type Pharmacy
Facility Name HEB PHARMACY 384
Street 6030 MONTGOMERY ROAD
City SAN ANTONIO
State TX
ZIP 78239
Phone 210 938-2384
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 LESLIE CASTILLO

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