45D2316650 CLIA NUMBER - MI CLINICA HISPANA LLC

Laboratory Demographics

  • CLIA Code: 45D2316650
  • Facility Name: MI CLINICA HISPANA LLC
  • Facility Address: 3505 SUMMERHILL ROAD STE 5
    TEXARKANA, TX
    ZIP 75503
  • Facility Phone: 903 710-1400
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ALAINA HERNANDEZ
  • NPI Number: 1093525206
  • Taxonomy: 363LP2300X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 45D2316650
LAB Type Physician Office
Facility Name MI CLINICA HISPANA LLC
Street 3505 SUMMERHILL ROAD STE 5
City TEXARKANA
State TX
ZIP 75503
Phone 903 710-1400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/9/2025
Certificate Expiration Date 1/8/2027
Facility Type Physician Office
Lab Director ALAINA HERNANDEZ

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