45D2158880 CLIA NUMBER - ESSENTIAL MED CLINIC PLLC

Laboratory Demographics

  • CLIA Code: 45D2158880
  • Facility Name: ESSENTIAL MED CLINIC PLLC
  • Facility Address: 2810 N LOOP 1604, STE 102
    SAN ANTONIO, TX
    ZIP 78248
  • Facility Phone: 210 568-7555
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: FREDA COBBINAH
  • NPI Number: 1376033951
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D2158880
LAB Type Physician Office
Facility Name ESSENTIAL MED CLINIC PLLC
Street 2810 N LOOP 1604, STE 102
City SAN ANTONIO
State TX
ZIP 78248
Phone 210 568-7555
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/7/2024
Certificate Expiration Date 12/6/2026
Facility Type Physician Office
Lab Director FREDA COBBINAH

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This page was last updated on: 6/4/2025