45D2027480 CLIA NUMBER - TEXAS MEDCLINIC-SO

Laboratory Demographics

  • CLIA Code: 45D2027480
  • Facility Name: TEXAS MEDCLINIC-SO
  • Facility Address: 323 N LOOP 1604 W
    SAN ANTONIO, TX
    ZIP 78232
  • Facility Phone: 210 549-5893
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: KRISTEN A. KOCUREK
  • NPI Number: 1487019287
  • Taxonomy: 261QU0200X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 45D2027480
LAB Type Physician Office
Facility Name TEXAS MEDCLINIC-SO
Street 323 N LOOP 1604 W
City SAN ANTONIO
State TX
ZIP 78232
Phone 210 549-5893
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 7/26/2025
Certificate Expiration Date 7/25/2027
Facility Type Physician Office
Lab Director KRISTEN A. KOCUREK

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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