45D1053264 CLIA NUMBER - RIVERSIDE

Laboratory Demographics

  • CLIA Code: 45D1053264
  • Facility Name: RIVERSIDE
  • Facility Address: 2237 E RIVERSIDE DR STE 101-C
    AUSTIN, TX
    ZIP 78741
  • Facility Phone: 512 448-3778
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: EDITH OLIVERAS
  • NPI Number: 1003493784
  • Taxonomy: 261QE0002X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D1053264
LAB Type Physician Office
Facility Name RIVERSIDE
Street 2237 E RIVERSIDE DR STE 101-C
City AUSTIN
State TX
ZIP 78741
Phone 512 448-3778
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/1/2024
Certificate Expiration Date 4/30/2026
Facility Type Physician Office
Lab Director EDITH OLIVERAS

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