45D2283007 CLIA NUMBER - CLINICA FAMILIAR KYLE

Laboratory Demographics

CLIA Number: 45D2283007

Facility Name: CLINICA FAMILIAR KYLE

Facility Address:
21511 IH 35, SUITE 105
KYLE, TX
ZIP 78640
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Facility Phone Number: 512 262-7307

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1033975933

Taxonomy: 363LF0000X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	45D2283007
LAB Type	Physician Office
Facility Name	CLINICA FAMILIAR KYLE
Street	21511 IH 35, SUITE 105
City	KYLE
State	TX
ZIP	78640
Phone	512 262-7307
CertificateType	4
CertificateEffectiveDate	5/31/2023
CertificateExpirationDate	5/30/2025
FacilityType	Waiver

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