45D2042107 CLIA NUMBER - OMAR J PENA LOPEZ, MD PA ELSA CHILDREN'S CLINIC

Laboratory Demographics

  • CLIA Code: 45D2042107
  • Facility Name: OMAR J PENA LOPEZ, MD PA ELSA CHILDREN'S CLINIC
  • Facility Address: 410 S BROADWAY
    ELSA, TX
    ZIP 78543
  • Facility Phone: 956 262-9805
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: OMAR JOSE PENA LOPEZ
  • NPI Number: 1619149762
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 45D2042107
LAB Type Physician Office
Facility Name OMAR J PENA LOPEZ, MD PA ELSA CHILDREN'S CLINIC
Street 410 S BROADWAY
City ELSA
State TX
ZIP 78543
Phone 956 262-9805
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/6/2024
Certificate Expiration Date 6/5/2026
Facility Type Physician Office
Lab Director OMAR JOSE PENA LOPEZ

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