45D2014389 CLIA NUMBER - SAN ANTONIO KIDNEY DISEASE CENTER PHYSICIANS GROUP PLLC SEGUIN OFFICE

Laboratory Demographics

  • CLIA Code: 45D2014389
  • Facility Name: SAN ANTONIO KIDNEY DISEASE CENTER PHYSICIANS GROUP PLLC SEGUIN OFFICE
  • Facility Address: 1410 E WALNUT
    SEGUIN, TX
    ZIP 78155
  • Facility Phone: 830 401-4455
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: LIN Z. JOHNSON
  • NPI Number: 1174710040
  • Taxonomy: 207RN0300X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D2014389
LAB Type Physician Office
Facility Name SAN ANTONIO KIDNEY DISEASE CENTER PHYSICIANS GROUP PLLC SEGUIN OFFICE
Street 1410 E WALNUT
City SEGUIN
State TX
ZIP 78155
Phone 830 401-4455
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 10/7/2024
Certificate Expiration Date 10/6/2026
Facility Type Physician Office
Lab Director LIN Z. JOHNSON

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This page was last updated on: 6/4/2025