45D1077599 CLIA NUMBER - MISSION PEDIATRICS PA

Laboratory Demographics

  • CLIA Code: 45D1077599
  • Facility Name: MISSION PEDIATRICS PA
  • Facility Address: 1005 EAST COURT STREET SUITE 300
    SEGUIN, TX
    ZIP 78155
  • Facility Phone: 830 303-3400
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MICHELE M. LOPEZ-GLYNN MD
  • NPI Number: 1780873836
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 45D1077599
LAB Type Physician Office
Facility Name MISSION PEDIATRICS PA
Street 1005 EAST COURT STREET SUITE 300
City SEGUIN
State TX
ZIP 78155
Phone 830 303-3400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/14/2023
Certificate Expiration Date 12/13/2025
Facility Type Physician Office
Lab Director MICHELE M. LOPEZ-GLYNN MD

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