45D1093138 CLIA NUMBER - AQUA DIALYSIS SAN AUGUSTINE LLC

Laboratory Demographics

  • CLIA Code: 45D1093138
  • Facility Name: AQUA DIALYSIS SAN AUGUSTINE LLC
  • Facility Address: 403 NORTH MILAM ST
    SAN AUGUSTINE, TX
    ZIP 75972
  • Facility Phone: (936) 275-3600
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: MUHAMMAD A. MIR
  • NPI Number: 1649879230
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D1093138
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name AQUA DIALYSIS SAN AUGUSTINE LLC
Street 403 NORTH MILAM ST
City SAN AUGUSTINE
State TX
ZIP 75972
Phone 9362753600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/11/2024
Certificate Expiration Date 12/10/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director MUHAMMAD A. MIR

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This page was last updated on: 5/18/2026