45D1107719 CLIA NUMBER - ADVANCED SPINE AND PAIN CENTER

Laboratory Demographics

  • CLIA Code: 45D1107719
  • Facility Name: ADVANCED SPINE AND PAIN CENTER
  • Facility Address: 21 SPURS LANE STE 240
    SAN ANTONIO, TX
    ZIP 78240
  • Facility Phone: 210 690-0777
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ELLEN W. LIN MD
  • NPI Number: 1356529598
  • Taxonomy: 2081P2900X - Physical Medicine & Rehabilitation

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CLIA Record

Field Name Field Value
CLIA Number 45D1107719
LAB Type Physician Office
Facility Name ADVANCED SPINE AND PAIN CENTER
Street 21 SPURS LANE STE 240
City SAN ANTONIO
State TX
ZIP 78240
Phone 210 690-0777
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/12/2023
Certificate Expiration Date 11/11/2025
Facility Type Physician Office
Lab Director ELLEN W. LIN MD

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