Organization Active NPI

South Texas Regional Laboratories Inc

  • Clinical Medical Laboratory
  • Eagle Pass, TX
National Provider Identifier
1003247198
Registry record updated Nov 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
45D0938565 Issued in TX
Legal business name
SOUTH TEXAS REGIONAL LABORATORIES INC
Practice address
1975 N Veterans Blvd
Suite 5
Eagle Pass, TX 78852-6114
Phone
(210) 371-7888
Fax
(210) 399-0761
NPI assigned
Nov 28, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Leopoldo Sergio Cobos, MS, MT(ASCP)
Title
President
Phone
(210) 371-7888

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 45D0938565 TX Primary

Addresses

Primary practice location

1975 N Veterans Blvd
Suite 5
Eagle Pass, TX 78852-6114

Mailing address

PO Box 1628
Eagle Pass, TX 78853-1628
Phone (210) 371-7888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140613001415 TX Part B Supplier - Independent Clinical Laboratory 3870717804 Practice locations: Eagle Pass, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D0938565South Texas Regional Laboratories Inc1975 N Veterans Blvd, Suite 5-a, Eagle Pass, TX 78852Certificate of waiverAug 17, 2027

National Provider Directory

National Provider Directory

Locations

1975 N Veterans Blvd
Ste 5
Eagle Pass, TX 78852
Phone (830) 773-8044

2149 Del Rio Blvd
Ste 301
Eagle Pass, TX 78852
Phone (830) 776-7515

1975 N Veterans Blvd
Ste 5A
Eagle Pass, TX 78852
Phone (830) 776-3751

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1385596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448409600000",
    "number": "1003247198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1628",
            "city": "EAGLE PASS",
            "state": "TX",
            "postal_code": "788531628",
            "telephone_number": "210-371-7888",
            "fax_number": "210-399-0761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1975 N VETERANS BLVD",
            "address_2": "SUITE 5",
            "city": "EAGLE PASS",
            "state": "TX",
            "postal_code": "788526114",
            "telephone_number": "210-371-7888",
            "fax_number": "210-399-0761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH TEXAS REGIONAL LABORATORIES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-28",
        "last_updated": "2015-11-25",
        "status": "A",
        "authorized_official_last_name": "COBOS",
        "authorized_official_first_name": "LEOPOLDO",
        "authorized_official_middle_name": "SERGIO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "210-371-7888",
        "authorized_official_credential": "MS, MT(ASCP)"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "TX",
            "license": "45D0938565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle Pass, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.