45D1107176 CLIA NUMBER - MAGED MINA MD PA

Laboratory Demographics

  • CLIA Code: 45D1107176
  • Facility Name: MAGED MINA MD PA
  • Facility Address: 1202 E SONTERRA BLVD, SUITE 303
    SAN ANTONIO, TX
    ZIP 78258
  • Facility Phone: 210 402-6561
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MAGED MINA
  • NPI Number: 1184618472
  • Taxonomy: 207L00000X - Anesthesiology

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CLIA Record

Field Name Field Value
CLIA Number 45D1107176
LAB Type Physician Office
Facility Name MAGED MINA MD PA
Street 1202 E SONTERRA BLVD, SUITE 303
City SAN ANTONIO
State TX
ZIP 78258
Phone 210 402-6561
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/10/2025
Certificate Expiration Date 4/9/2027
Facility Type Physician Office
Lab Director MAGED MINA

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