45D2009212 CLIA NUMBER - WILLIAM A TISDALL MD

Laboratory Demographics

  • CLIA Code: 45D2009212
  • Facility Name: WILLIAM A TISDALL MD
  • Facility Address: 1919 ROGERS ROAD SUITE 104
    SAN ANTONIO, TX
    ZIP 78251
  • Facility Phone: 210 541-0700
  • Facility Type: Physician Office
  • Facility Type: Accreditation
  • Lab Director: DR. GAAYANA A. RAJU
  • NPI Number: 1124153754
  • Taxonomy: 208VP0014X - Pain Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D2009212
LAB Type Physician Office
Facility Name WILLIAM A TISDALL MD
Street 1919 ROGERS ROAD SUITE 104
City SAN ANTONIO
State TX
ZIP 78251
Phone 210 541-0700
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 2/12/2024
Certificate Expiration Date 2/11/2026
Facility Type Physician Office
Lab Director DR. GAAYANA A. RAJU

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