45D2263253 CLIA NUMBER - CLINICAL LATINA SAN RAFAEL

Laboratory Demographics

CLIA Number: 45D2263253

Facility Name: CLINICAL LATINA SAN RAFAEL

Facility Address:
1620 S PADRE ISLAND DRIVE, SUITE 180
CORPUS CHRISTI, TX
ZIP 78416
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Facility Phone Number: 361 221-1905

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1548991037

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	45D2263253
LAB Type	Physician Office
Facility Name	CLINICAL LATINA SAN RAFAEL
Street	1620 S PADRE ISLAND DRIVE, SUITE 180
City	CORPUS CHRISTI
State	TX
ZIP	78416
Phone	361 221-1905
CertificateType	4
CertificateEffectiveDate	6/24/2022
CertificateExpirationDate	6/23/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024