45D1078368 CLIA NUMBER - ORTHOPEDIC IMAGING CENTER TEXAS CENTER FOR ATHLETES SUBLEVEL (SL) - 140

Laboratory Demographics

  • CLIA Code: 45D1078368
  • Facility Name: ORTHOPEDIC IMAGING CENTER TEXAS CENTER FOR ATHLETES SUBLEVEL (SL) - 140
  • Facility Address: 21 SPURS LANE
    SAN ANTONIO, TX
    ZIP 78240
  • Facility Phone: 210 617-9100
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARK S. YAHN
  • NPI Number: 1972916054
  • Taxonomy: 261QP2000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D1078368
LAB Type Physician Office
Facility Name ORTHOPEDIC IMAGING CENTER TEXAS CENTER FOR ATHLETES SUBLEVEL (SL) - 140
Street 21 SPURS LANE
City SAN ANTONIO
State TX
ZIP 78240
Phone 210 617-9100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/8/2024
Certificate Expiration Date 1/7/2026
Facility Type Physician Office
Lab Director MARK S. YAHN

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This page was last updated on: 6/4/2025