45D2290044 CLIA NUMBER - EAGLE PASS PEDIATRIC HEALTH CLINIC

Laboratory Demographics

  • CLIA Code: 45D2290044
  • Facility Name: EAGLE PASS PEDIATRIC HEALTH CLINIC
  • Facility Address: 710 WILLIAMS ST
    EAGLE PASS, TX
    ZIP 78852
  • Facility Phone: 830 773-1103
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: RICARDO DE LOS SANTOS
  • NPI Number: 1043472780
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D2290044
LAB Type Rural Health Clinic
Facility Name EAGLE PASS PEDIATRIC HEALTH CLINIC
Street 710 WILLIAMS ST
City EAGLE PASS
State TX
ZIP 78852
Phone 830 773-1103
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/19/2025
Certificate Expiration Date 9/18/2027
Facility Type Rural Health Clinic
Lab Director RICARDO DE LOS SANTOS

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