45D2194750 CLIA NUMBER - ESTATES AT SHAVANO PARK

Laboratory Demographics

  • CLIA Code: 45D2194750
  • Facility Name: ESTATES AT SHAVANO PARK
  • Facility Address: 6601 BLANCO ROAD, SUITE 150
    SAN ANTONIO, TX
    ZIP 78216
  • Facility Phone: 210 525-8802
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: DANIEL PRINCE
  • NPI Number: 1538770839
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 45D2194750
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name ESTATES AT SHAVANO PARK
Street 6601 BLANCO ROAD, SUITE 150
City SAN ANTONIO
State TX
ZIP 78216
Phone 210 525-8802
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/2/2024
Certificate Expiration Date 10/1/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director DANIEL PRINCE

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