45D2246002 CLIA NUMBER - YELED SHALOM PEDIATRIC CLINIC

Laboratory Demographics

  • CLIA Code: 45D2246002
  • Facility Name: YELED SHALOM PEDIATRIC CLINIC
  • Facility Address: 1975 N VETERANS BLVD, STE 7
    EAGLE PASS, TX
    ZIP 78852
  • Facility Phone: 830 773-9449
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: ELIEZER HERNANDEZ
  • NPI Number: 1770540684
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D2246002
LAB Type Rural Health Clinic
Facility Name YELED SHALOM PEDIATRIC CLINIC
Street 1975 N VETERANS BLVD, STE 7
City EAGLE PASS
State TX
ZIP 78852
Phone 830 773-9449
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/20/2023
Certificate Expiration Date 12/19/2025
Facility Type Rural Health Clinic
Lab Director ELIEZER HERNANDEZ

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