45D2067229 CLIA NUMBER - SOBA TEXAS LLC

Laboratory Demographics

  • CLIA Code: 45D2067229
  • Facility Name: SOBA TEXAS LLC
  • Facility Address: 1401 DEZARAE LOT #3
    SAN ANTONIO, TX
    ZIP 78253
  • Facility Phone: 310 457-5250
  • Facility Type: Other - TREATMENT CENTER
  • Facility Type: Waiver
  • Lab Director: CALLIE WILLIAMSON
  • NPI Number: 1336599182
  • Taxonomy: 261QR0405X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D2067229
LAB Type Other - TREATMENT CENTER
Facility Name SOBA TEXAS LLC
Street 1401 DEZARAE LOT #3
City SAN ANTONIO
State TX
ZIP 78253
Phone 310 457-5250
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/10/2025
Certificate Expiration Date 10/9/2027
Facility Type Other - TREATMENT CENTER
Lab Director CALLIE WILLIAMSON

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