45D0903673 CLIA NUMBER - SOUTH AUSTIN CANCER CENTER/BRENDA BURNS

Laboratory Demographics

CLIA Number: 45D0903673

Facility Name: SOUTH AUSTIN CANCER CENTER/BRENDA BURNS

Facility Address:
4101 JAMES CASEY SUITE 100
AUSTIN, TX
ZIP 78745
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Facility Phone Number: 512 447-2202

Facility Type: Physician Office

Certificate Type: Accreditation

NPI Number: 1629123765

Taxonomy: 261QR0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	45D0903673
LAB Type	Physician Office
Facility Name	SOUTH AUSTIN CANCER CENTER/BRENDA BURNS
Street	4101 JAMES CASEY SUITE 100
City	AUSTIN
State	TX
ZIP	78745
Phone	512 447-2202
CertificateType	1
CertificateEffectiveDate	12/15/2023
CertificateExpirationDate	12/14/2025
FacilityType	Accreditation

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This page was last updated on: 4/23/2024