45D2186559 CLIA NUMBER - CONVIVA MEDICAL CENTER MANAGEMENT OF TEXAS PA DBA CONVIVA CARE CENTER

Laboratory Demographics

  • CLIA Code: 45D2186559
  • Facility Name: CONVIVA MEDICAL CENTER MANAGEMENT OF TEXAS PA DBA CONVIVA CARE CENTER
  • Facility Address: 100 S ZARZAMORA
    SAN ANTONIO, TX
    ZIP 78207
  • Facility Phone: 210 761-3393
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: VIVIAN M. AYOUB
  • NPI Number: 1629734793
  • Taxonomy: 208D00000X - General Practice

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CLIA Record

Field Name Field Value
CLIA Number 45D2186559
LAB Type Physician Office
Facility Name CONVIVA MEDICAL CENTER MANAGEMENT OF TEXAS PA DBA CONVIVA CARE CENTER
Street 100 S ZARZAMORA
City SAN ANTONIO
State TX
ZIP 78207
Phone 210 761-3393
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/18/2024
Certificate Expiration Date 6/17/2026
Facility Type Physician Office
Lab Director VIVIAN M. AYOUB

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