45D1106816 CLIA NUMBER - SAN ANTONIO FIGHTING BACK INC

Laboratory Demographics

CLIA Number: 45D1106816

Facility Name: SAN ANTONIO FIGHTING BACK INC

Facility Address:
2803 E COMMERCE
SAN ANTONIO, TX
ZIP 78203
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Facility Phone Number: 210 271-7232

Facility Type: Other

Certificate Type: Waiver

NPI Number: 1689980989

Taxonomy: 101YP2500X - Counselor

CLIA Record

Field Name	Field Value
CLIA Number	45D1106816
LAB Type	Other
Facility Name	SAN ANTONIO FIGHTING BACK INC
Street	2803 E COMMERCE
City	SAN ANTONIO
State	TX
ZIP	78203
Phone	210 271-7232
CertificateType	4
CertificateEffectiveDate	10/22/2023
CertificateExpirationDate	10/21/2025
FacilityType	Waiver

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