45D2028694 CLIA NUMBER - TWIN FOUNTAINS URGENT CARE CENTER

Laboratory Demographics

  • CLIA Code: 45D2028694
  • Facility Name: TWIN FOUNTAINS URGENT CARE CENTER
  • Facility Address: 108 TWIN FOUNTAINS DRIVE
    VICTORIA, TX
    ZIP 77904
  • Facility Phone: 361 578-3363
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. BAIN CHODOROV CATE
  • NPI Number: 1598078453
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D2028694
LAB Type Physician Office
Facility Name TWIN FOUNTAINS URGENT CARE CENTER
Street 108 TWIN FOUNTAINS DRIVE
City VICTORIA
State TX
ZIP 77904
Phone 361 578-3363
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/23/2023
Certificate Expiration Date 8/22/2025
Facility Type Physician Office
Lab Director DR. BAIN CHODOROV CATE

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This page was last updated on: 3/20/2025