45D2060791 CLIA NUMBER - PRO-CARE MEDICAL CENTER

Laboratory Demographics

  • CLIA Code: 45D2060791
  • Facility Name: PRO-CARE MEDICAL CENTER
  • Facility Address: 9502 HUEBNER ROAD, SUITE 102
    SAN ANTONIO, TX
    ZIP 78240
  • Facility Phone: 512 371-7478
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOHNNY L. WHITE
  • NPI Number: 1457500035
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D2060791
LAB Type Physician Office
Facility Name PRO-CARE MEDICAL CENTER
Street 9502 HUEBNER ROAD, SUITE 102
City SAN ANTONIO
State TX
ZIP 78240
Phone 512 371-7478
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/18/2025
Certificate Expiration Date 6/17/2027
Facility Type Physician Office
Lab Director JOHNNY L. WHITE

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