45D2325959 CLIA NUMBER - PROJECT VIDA HEALTH CENTER: FERNANDEZ CLINIC

Laboratory Demographics

  • CLIA Code: 45D2325959
  • Facility Name: PROJECT VIDA HEALTH CENTER: FERNANDEZ CLINIC
  • Facility Address: 4304 DYER STREET
    EL PASO, TX
    ZIP 79930
  • Facility Phone: 915 465-1191
  • Facility Type: Federally Qualified Health Center
  • Facility Type: Waiver
  • Lab Director: TIM DAVENPORT-HERBST
  • NPI Number: 1609699206
  • Taxonomy: 261QF0400X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D2325959
LAB Type Federally Qualified Health Center
Facility Name PROJECT VIDA HEALTH CENTER: FERNANDEZ CLINIC
Street 4304 DYER STREET
City EL PASO
State TX
ZIP 79930
Phone 915 465-1191
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/24/2025
Certificate Expiration Date 6/23/2027
Facility Type Federally Qualified Health Center
Lab Director TIM DAVENPORT-HERBST

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