45D1076577 CLIA NUMBER - EAR MEDICAL GROUP

Laboratory Demographics

CLIA Number: 45D1076577

Facility Name: EAR MEDICAL GROUP

Facility Address:
21 SPURS LANE #245 ATTN SUSAN KING
SAN ANTONIO, TX
ZIP 78240
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Facility Phone Number: 210 614-6070

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1164533246

Taxonomy: 207YX0901X - Otolaryngology
An otolaryngologist who treats diseases of the ear and temporal bone, including disorders of hearing and balance. The additional training in otology and neurotology emphasizes the study of embryology, anatomy, physiology, epidemiology, pathophysiology, pathology, genetics, immunology, microbiology and the etiology of diseases of the ear and temporal bone.

CLIA Record

Field Name	Field Value
CLIA Number	45D1076577
LAB Type	Physician Office
Facility Name	EAR MEDICAL GROUP
Street	21 SPURS LANE #245 ATTN SUSAN KING
City	SAN ANTONIO
State	TX
ZIP	78240
Phone	210 614-6070
CertificateType	4
CertificateEffectiveDate	11/16/2023
CertificateExpirationDate	11/15/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024