45D2179810 CLIA NUMBER - LAVACA BAY NURSING AND REHABILITATION

Laboratory Demographics

  • CLIA Code: 45D2179810
  • Facility Name: LAVACA BAY NURSING AND REHABILITATION
  • Facility Address: 118 TRINITY SHORES DRIVE
    PORT LAVACA, TX
    ZIP 77979
  • Facility Phone: 361 551-0500
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: ERIC TEEHAN
  • NPI Number: 1497143259
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 45D2179810
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name LAVACA BAY NURSING AND REHABILITATION
Street 118 TRINITY SHORES DRIVE
City PORT LAVACA
State TX
ZIP 77979
Phone 361 551-0500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/3/2024
Certificate Expiration Date 3/2/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director ERIC TEEHAN

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