45D1095267 CLIA NUMBER - TJELMELAND PLASTIC SURGERY PA

Laboratory Demographics

  • CLIA Code: 45D1095267
  • Facility Name: TJELMELAND PLASTIC SURGERY PA
  • Facility Address: 4220 BULL CREEK ROAD
    AUSTIN, TX
    ZIP 78731
  • Facility Phone: 512 617-7500
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KELLY E. TJELMELAND
  • NPI Number: 1710071832
  • Taxonomy: 208200000X - Plastic Surgery

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CLIA Record

Field Name Field Value
CLIA Number 45D1095267
LAB Type Physician Office
Facility Name TJELMELAND PLASTIC SURGERY PA
Street 4220 BULL CREEK ROAD
City AUSTIN
State TX
ZIP 78731
Phone 512 617-7500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/5/2025
Certificate Expiration Date 2/4/2027
Facility Type Physician Office
Lab Director KELLY E. TJELMELAND

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