45D2263256 CLIA NUMBER - CLINICA LATINA DIVINO NAZARENO

Laboratory Demographics

CLIA Number: 45D2263256

Facility Name: CLINICA LATINA DIVINO NAZARENO

Facility Address:
4458 S STAPLES
CORPUS CHRISTI, TX
ZIP 78411
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Facility Phone Number: 361 236-4382

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1710618210

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	45D2263256
LAB Type	Physician Office
Facility Name	CLINICA LATINA DIVINO NAZARENO
Street	4458 S STAPLES
City	CORPUS CHRISTI
State	TX
ZIP	78411
Phone	361 236-4382
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