45D1073188 CLIA NUMBER - STONEGATE PHARMACY

Laboratory Demographics

  • CLIA Code: 45D1073188
  • Facility Name: STONEGATE PHARMACY
  • Facility Address: 2501 W WILLIAM CANNON 203
    AUSTIN, TX
    ZIP 78745
  • Facility Phone: 512 707-2300
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RENE F. GARZA
  • NPI Number: 1578505145
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D1073188
LAB Type Pharmacy
Facility Name STONEGATE PHARMACY
Street 2501 W WILLIAM CANNON 203
City AUSTIN
State TX
ZIP 78745
Phone 512 707-2300
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/7/2024
Certificate Expiration Date 4/6/2026
Facility Type Pharmacy
Lab Director RENE F. GARZA

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