45D2260365 CLIA NUMBER - EVOLVE SPECIALTY PHARMACY & WELLNESS

Laboratory Demographics

  • CLIA Code: 45D2260365
  • Facility Name: EVOLVE SPECIALTY PHARMACY & WELLNESS
  • Facility Address: 19239 STONE OAK PARKWAY STE #103
    SAN ANTONIO, TX
    ZIP 78258
  • Facility Phone: 210 314-6464
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AL-GHOUL LUBNA
  • NPI Number: 1730833310
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 45D2260365
LAB Type Pharmacy
Facility Name EVOLVE SPECIALTY PHARMACY & WELLNESS
Street 19239 STONE OAK PARKWAY STE #103
City SAN ANTONIO
State TX
ZIP 78258
Phone 210 314-6464
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/18/2024
Certificate Expiration Date 5/17/2026
Facility Type Pharmacy
Lab Director AL-GHOUL LUBNA

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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