45D1101758 CLIA NUMBER - KEVIN STEPHENS MD PA

Laboratory Demographics

CLIA Number: 45D1101758

Facility Name: KEVIN STEPHENS MD PA

Facility Address:
4100 DUVAL RD BLD 2 STE 202
AUSTIN, TX
ZIP 78759
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Facility Phone Number: 512 454-1123

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1255414314

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	45D1101758
LAB Type	Physician Office
Facility Name	KEVIN STEPHENS MD PA
Street	4100 DUVAL RD BLD 2 STE 202
City	AUSTIN
State	TX
ZIP	78759
Phone	512 454-1123
CertificateType	4
CertificateEffectiveDate	7/6/2023
CertificateExpirationDate	7/5/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024