45D2052413 CLIA NUMBER - LORI HICKSON MD PA

Laboratory Demographics

  • CLIA Code: 45D2052413
  • Facility Name: LORI HICKSON MD PA
  • Facility Address: 1619 E COMMON ST BLDG L SUITE 1201
    NEW BRAUNFELS, TX
    ZIP 78130
  • Facility Phone: 949 836-6846
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LORI A. HICKSON MD
  • NPI Number: 1235196163
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D2052413
LAB Type Physician Office
Facility Name LORI HICKSON MD PA
Street 1619 E COMMON ST BLDG L SUITE 1201
City NEW BRAUNFELS
State TX
ZIP 78130
Phone 949 836-6846
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/10/2025
Certificate Expiration Date 1/9/2027
Facility Type Physician Office
Lab Director LORI A. HICKSON MD

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