45D2079863 CLIA NUMBER - GASTROENTEROLOGY CONSULTANTS OF SA PROTON

Laboratory Demographics

  • CLIA Code: 45D2079863
  • Facility Name: GASTROENTEROLOGY CONSULTANTS OF SA PROTON
  • Facility Address: 855 PROTON ROAD
    SAN ANTONIO, TX
    ZIP 78258
  • Facility Phone: 210 614-1234
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: JAMES E. JACKSON
  • NPI Number: 1225375587
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D2079863
LAB Type Ambulatory Surgery Center
Facility Name GASTROENTEROLOGY CONSULTANTS OF SA PROTON
Street 855 PROTON ROAD
City SAN ANTONIO
State TX
ZIP 78258
Phone 210 614-1234
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/25/2024
Certificate Expiration Date 6/24/2026
Facility Type Ambulatory Surgery Center
Lab Director JAMES E. JACKSON

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