45D2049779 CLIA NUMBER - COASTAL BEND FAMILY MEDICINE PA

Laboratory Demographics

  • CLIA Code: 45D2049779
  • Facility Name: COASTAL BEND FAMILY MEDICINE PA
  • Facility Address: 4818 HOLLY ROAD SUITE A
    CORPUS CHRISTI, TX
    ZIP 78411
  • Facility Phone: 361 993-1747
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DAVID L. VANDERHEIDEN
  • NPI Number: 1639408974
  • Taxonomy: 207Q00000X - Family Medicine

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 45D2049779
LAB Type Physician Office
Facility Name COASTAL BEND FAMILY MEDICINE PA
Street 4818 HOLLY ROAD SUITE A
City CORPUS CHRISTI
State TX
ZIP 78411
Phone 361 993-1747
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 11/14/2024
Certificate Expiration Date 11/13/2026
Facility Type Physician Office
Lab Director DAVID L. VANDERHEIDEN

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