45D2007116 CLIA NUMBER - PEGASUS PEDIATRICS PA

Laboratory Demographics

  • CLIA Code: 45D2007116
  • Facility Name: PEGASUS PEDIATRICS PA
  • Facility Address: 1020 TOWNSEND AVE
    SAN ANTONIO, TX
    ZIP 78209
  • Facility Phone: 210 370-3061
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BENJAMIN L. SMITH
  • NPI Number: 1215268776
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 45D2007116
LAB Type Physician Office
Facility Name PEGASUS PEDIATRICS PA
Street 1020 TOWNSEND AVE
City SAN ANTONIO
State TX
ZIP 78209
Phone 210 370-3061
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/7/2024
Certificate Expiration Date 5/6/2026
Facility Type Physician Office
Lab Director BENJAMIN L. SMITH

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