45D2172412 CLIA NUMBER - CENTRO SA PEDIATRICS PROMESA

Laboratory Demographics

  • CLIA Code: 45D2172412
  • Facility Name: CENTRO SA PEDIATRICS PROMESA
  • Facility Address: 1314 GUADALUPE ST, SUITE 107
    SAN ANTONIO, TX
    ZIP 78207
  • Facility Phone: 210 977-1903
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: NORMA PARRA
  • NPI Number: 1841433562
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D2172412
LAB Type Federally Qualified Health Center
Facility Name CENTRO SA PEDIATRICS PROMESA
Street 1314 GUADALUPE ST, SUITE 107
City SAN ANTONIO
State TX
ZIP 78207
Phone 210 977-1903
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/23/2025
Certificate Expiration Date 9/22/2027
Facility Type Federally Qualified Health Center
Lab Director NORMA PARRA

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