45D2250392 CLIA NUMBER - JORDAN C WHITE D C LLC

Laboratory Demographics

  • CLIA Code: 45D2250392
  • Facility Name: JORDAN C WHITE D C LLC
  • Facility Address: 5169 RANDOLPH BLVD
    SAN ANTONIO, TX
    ZIP 78233
  • Facility Phone: 210 275-4600
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JORDAN WHITE
  • NPI Number: 1992364970
  • Taxonomy: 363A00000X - Physician Assistant

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CLIA Record

Field Name Field Value
CLIA Number 45D2250392
LAB Type Physician Office
Facility Name JORDAN C WHITE D C LLC
Street 5169 RANDOLPH BLVD
City SAN ANTONIO
State TX
ZIP 78233
Phone 210 275-4600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/26/2024
Certificate Expiration Date 1/25/2026
Facility Type Physician Office
Lab Director JORDAN WHITE

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