45D2149696 CLIA NUMBER - THIRD COAST HEALTH

Laboratory Demographics

CLIA Number: 45D2149696

Facility Name: THIRD COAST HEALTH

Facility Address:
3560 S ALAMEDA # 4
CORPUS CHRISTI, TX
ZIP 78411
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Facility Phone Number: 361 900-9969

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1902044316

Taxonomy: 208D00000X - General Practice
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

CLIA Record

Field Name	Field Value
CLIA Number	45D2149696
LAB Type	Physician Office
Facility Name	THIRD COAST HEALTH
Street	3560 S ALAMEDA # 4
City	CORPUS CHRISTI
State	TX
ZIP	78411
Phone	361 900-9969
CertificateType	4
CertificateEffectiveDate	6/8/2022
CertificateExpirationDate	6/7/2024
FacilityType	Waiver

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