Organization
LSA SA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY RIELY (ADMINISTRATOR)
(210) 410-2563
Entity
Organization
Contact information
Practice address
8812 BROADWAY ST, SAN ANTONIO, TX 78217-6318
(210) 829-5662
(210) 829-5630
Mailing address
8812 BROADWAY ST, SAN ANTONIO, TX 78217-6318
(210) 829-5662
(210) 829-5630
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Enumeration date
04/07/2015
Last updated
04/07/2015
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