45D1103328 CLIA NUMBER - PROVIDENCE HEALTH CLINIC

Laboratory Demographics

  • CLIA Code: 45D1103328
  • Facility Name: PROVIDENCE HEALTH CLINIC
  • Facility Address: 230 CALLE DEL NORTE
    LAREDO, TX
    ZIP 78041
  • Facility Phone: 956 693-5017
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: KIM DAVID MURPHY
  • NPI Number: 1730265299
  • Taxonomy: 207L00000X - Anesthesiology

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CLIA Record

Field Name Field Value
CLIA Number 45D1103328
LAB Type Community Clinic
Facility Name PROVIDENCE HEALTH CLINIC
Street 230 CALLE DEL NORTE
City LAREDO
State TX
ZIP 78041
Phone 956 693-5017
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/7/2025
Certificate Expiration Date 8/6/2027
Facility Type Community Clinic
Lab Director KIM DAVID MURPHY

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