45D1077713 CLIA NUMBER - LIGHTHOUSE HEALTH CLINIC DBA LIGHTHOUSE PEDIATRICS

Laboratory Demographics

  • CLIA Code: 45D1077713
  • Facility Name: LIGHTHOUSE HEALTH CLINIC DBA LIGHTHOUSE PEDIATRICS
  • Facility Address: 601 E WHITESTONE BLVD SUITE # 308
    CEDAR PARK, TX
    ZIP 78613
  • Facility Phone: 512 528-9996
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: LINDA S. DONOVAN
  • NPI Number: 1780710319
  • Taxonomy: 363LP0200X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 45D1077713
LAB Type Physician Office
Facility Name LIGHTHOUSE HEALTH CLINIC DBA LIGHTHOUSE PEDIATRICS
Street 601 E WHITESTONE BLVD SUITE # 308
City CEDAR PARK
State TX
ZIP 78613
Phone 512 528-9996
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/18/2023
Certificate Expiration Date 12/17/2025
Facility Type Physician Office
Lab Director LINDA S. DONOVAN

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