45D2036703 CLIA NUMBER - CLINICA SAGRADO CORAZON

Laboratory Demographics

  • CLIA Code: 45D2036703
  • Facility Name: CLINICA SAGRADO CORAZON
  • Facility Address: 3401 W 5 MILE ROAD SUITE 1
    MISSION, TX
    ZIP 78574
  • Facility Phone: 956 580-2145
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. PABLO OLMEDO
  • NPI Number: 1770860116
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D2036703
LAB Type Physician Office
Facility Name CLINICA SAGRADO CORAZON
Street 3401 W 5 MILE ROAD SUITE 1
City MISSION
State TX
ZIP 78574
Phone 956 580-2145
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/26/2023
Certificate Expiration Date 12/25/2025
Facility Type Physician Office
Lab Director DR. PABLO OLMEDO

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