45D2316423 CLIA NUMBER - WITS SPECIALTY CLINIC PLLC

Laboratory Demographics

  • CLIA Code: 45D2316423
  • Facility Name: WITS SPECIALTY CLINIC PLLC
  • Facility Address: 9000 TESORO DRIVE DR SUITE 103
    SAN ANTONIO, TX
    ZIP 78217
  • Facility Phone: 210 794-7726
  • Facility Type: Other - MENTAL HEALTH CLINIC
  • Facility Type: Waiver
  • Lab Director: AUDREY MOODY
  • NPI Number: 1528810439
  • Taxonomy: 2084P0800X - Psychiatry & Neurology

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CLIA Record

Field Name Field Value
CLIA Number 45D2316423
LAB Type Other - MENTAL HEALTH CLINIC
Facility Name WITS SPECIALTY CLINIC PLLC
Street 9000 TESORO DRIVE DR SUITE 103
City SAN ANTONIO
State TX
ZIP 78217
Phone 210 794-7726
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/6/2025
Certificate Expiration Date 1/5/2027
Facility Type Other - MENTAL HEALTH CLINIC
Lab Director AUDREY MOODY

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