45D1020077 CLIA NUMBER - UNIVERSITY OF TEXAS UNIVERSITY HEALTH SERVICES

Laboratory Demographics

  • CLIA Code: 45D1020077
  • Facility Name: UNIVERSITY OF TEXAS UNIVERSITY HEALTH SERVICES
  • Facility Address: 100 WEST DEAN KEETON STREET SSB ROOM 2 1026
    AUSTIN, TX
    ZIP 78712
  • Facility Phone: 512 475-8349
  • Facility Type: School/Student Health Service
  • Facility Type: Microscopy
  • Lab Director: DAVID VANDER STRATEN
  • NPI Number: 1740313337
  • Taxonomy: 261QH0100X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D1020077
LAB Type School/Student Health Service
Facility Name UNIVERSITY OF TEXAS UNIVERSITY HEALTH SERVICES
Street 100 WEST DEAN KEETON STREET SSB ROOM 2 1026
City AUSTIN
State TX
ZIP 78712
Phone 512 475-8349
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 8/11/2025
Certificate Expiration Date 8/10/2027
Facility Type School/Student Health Service
Lab Director DAVID VANDER STRATEN

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