45D1071621 CLIA NUMBER - HEB PHARMACY #415

Laboratory Demographics

  • CLIA Code: 45D1071621
  • Facility Name: HEB PHARMACY #415
  • Facility Address: 646 S FLORES STREET SOUTH 1 RX
    SAN ANTONIO, TX
    ZIP 78204
  • Facility Phone: 210 938-2063
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANTONY BRAY
  • NPI Number: 1902915341
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D1071621
LAB Type Pharmacy
Facility Name HEB PHARMACY #415
Street 646 S FLORES STREET SOUTH 1 RX
City SAN ANTONIO
State TX
ZIP 78204
Phone 210 938-2063
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 ANTONY BRAY

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