45D2185462 CLIA NUMBER - INNOVATIVE URGENT CARE AND FAMILY HEALTH

Laboratory Demographics

  • CLIA Code: 45D2185462
  • Facility Name: INNOVATIVE URGENT CARE AND FAMILY HEALTH
  • Facility Address: 910 12TH STREET, STE A
    BANDERA, TX
    ZIP 78003
  • Facility Phone: 210 455-6253
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: PETER SCHANEN
  • NPI Number: 1013383801
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 45D2185462
LAB Type Practitioner Other
Facility Name INNOVATIVE URGENT CARE AND FAMILY HEALTH
Street 910 12TH STREET, STE A
City BANDERA
State TX
ZIP 78003
Phone 210 455-6253
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/4/2024
Certificate Expiration Date 6/3/2026
Facility Type Practitioner Other
Lab Director PETER SCHANEN

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