45D2118796 CLIA NUMBER - PONCE MEDICAL

Laboratory Demographics

  • CLIA Code: 45D2118796
  • Facility Name: PONCE MEDICAL
  • Facility Address: 2449 BOCA CHICA BLVD STE A
    BROWNSVILLE, TX
    ZIP 78521
  • Facility Phone: 956 350-2993
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ALEJANDRA PONCE
  • NPI Number: 1386092617
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D2118796
LAB Type Physician Office
Facility Name PONCE MEDICAL
Street 2449 BOCA CHICA BLVD STE A
City BROWNSVILLE
State TX
ZIP 78521
Phone 956 350-2993
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/14/2024
Certificate Expiration Date 9/13/2026
Facility Type Physician Office
Lab Director ALEJANDRA PONCE

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