45D2058619 CLIA NUMBER - UTHSCSA - IIMS FIRST PROGRAM

Laboratory Demographics

  • CLIA Code: 45D2058619
  • Facility Name: UTHSCSA - IIMS FIRST PROGRAM
  • Facility Address: 7400 MERTON MINTER AUDIE L MURPHY VA HOSPITAL UNIT 7A
    SAN ANTONIO, TX
    ZIP 78229
  • Facility Phone: 210 450-9028
  • Facility Type: Other - RESEARCH CLINIC
  • Facility Type: Waiver
  • Lab Director: ROBERT A. CLARK
  • NPI Number: 1639508799
  • Taxonomy: 305R00000X - Preferred Provider Organization

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CLIA Record

Field Name Field Value
CLIA Number 45D2058619
LAB Type Other - RESEARCH CLINIC
Facility Name UTHSCSA - IIMS FIRST PROGRAM
Street 7400 MERTON MINTER AUDIE L MURPHY VA HOSPITAL UNIT 7A
City SAN ANTONIO
State TX
ZIP 78229
Phone 210 450-9028
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/9/2025
Certificate Expiration Date 5/8/2027
Facility Type Other - RESEARCH CLINIC
Lab Director ROBERT A. CLARK

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