45D2140881 CLIA NUMBER - DIABETES AND ENDOCRINOLOGY INSTITUTE OF RENAISSANC

Laboratory Demographics

CLIA Number: 45D2140881

Facility Name: DIABETES AND ENDOCRINOLOGY INSTITUTE OF RENAISSANC

Facility Address:
2821 MICHALEANGELO DRIVE, SUITE 102A
EDINBURG, TX
ZIP 78539
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Facility Phone Number: 956 362-5650

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1831266451

Taxonomy: 174400000X - Specialist
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

CLIA Record

Field Name	Field Value
CLIA Number	45D2140881
LAB Type	Physician Office
Facility Name	DIABETES AND ENDOCRINOLOGY INSTITUTE OF RENAISSANC
Street	2821 MICHALEANGELO DRIVE, SUITE 102A
City	EDINBURG
State	TX
ZIP	78539
Phone	956 362-5650
CertificateType	4
CertificateEffectiveDate	12/4/2023
CertificateExpirationDate	12/3/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024