45D2289118 CLIA NUMBER - PROACTIVE MD TINDALL SAN ANTONIO HEALTH CENTER

Laboratory Demographics

  • CLIA Code: 45D2289118
  • Facility Name: PROACTIVE MD TINDALL SAN ANTONIO HEALTH CENTER
  • Facility Address: 2222 WEST MALONE AVE
    SAN ANTONIO, TX
    ZIP 78225
  • Facility Phone: 210 660-4646
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: LANA BROOKS
  • NPI Number: 1245013192
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D2289118
LAB Type Practitioner Other
Facility Name PROACTIVE MD TINDALL SAN ANTONIO HEALTH CENTER
Street 2222 WEST MALONE AVE
City SAN ANTONIO
State TX
ZIP 78225
Phone 210 660-4646
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/6/2025
Certificate Expiration Date 9/5/2027
Facility Type Practitioner Other
Lab Director LANA BROOKS

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