45D2270521 CLIA NUMBER - PRODIGIOUS HOSPICES LLC

Laboratory Demographics

  • CLIA Code: 45D2270521
  • Facility Name: PRODIGIOUS HOSPICES LLC
  • Facility Address: 9000 TESORO DRIVE, STE 107
    SAN ANTONIO, TX
    ZIP 78217
  • Facility Phone: 210 946-1367
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: COLACINO GEOFF
  • NPI Number: 1245978378
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 45D2270521
LAB Type Hospice
Facility Name PRODIGIOUS HOSPICES LLC
Street 9000 TESORO DRIVE, STE 107
City SAN ANTONIO
State TX
ZIP 78217
Phone 210 946-1367
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/17/2024
Certificate Expiration Date 10/16/2026
Facility Type Hospice
Lab Director COLACINO GEOFF

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