45D1075547 CLIA NUMBER - CHILDREN'S MEDICAL GROUP OF AUSTIN, PLLC

Laboratory Demographics

  • CLIA Code: 45D1075547
  • Facility Name: CHILDREN'S MEDICAL GROUP OF AUSTIN, PLLC
  • Facility Address: 631 W. 38TH STREET, SUITE 3
    AUSTIN, TX
    ZIP 78705
  • Facility Phone: 512 451-5161
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TAMMY S. MCCONNELL
  • NPI Number: 1225003783
  • Taxonomy: 207W00000X - Ophthalmology

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 45D1075547
LAB Type Physician Office
Facility Name CHILDREN'S MEDICAL GROUP OF AUSTIN, PLLC
Street 631 W. 38TH STREET, SUITE 3
City AUSTIN
State TX
ZIP 78705
Phone 512 451-5161
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/23/2023
Certificate Expiration Date 10/22/2025
Facility Type Physician Office
Lab Director TAMMY S. MCCONNELL

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

This page was last updated on: 6/4/2025