45D1101783 CLIA NUMBER - NORTH AUSTIN MATERNAL FETAL MEDICINE PLLC

Laboratory Demographics

  • CLIA Code: 45D1101783
  • Facility Name: NORTH AUSTIN MATERNAL FETAL MEDICINE PLLC
  • Facility Address: 12200 RENFERT WAY SUITE G-3
    AUSTIN, TX
    ZIP 78758
  • Facility Phone: 512 821-2540
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KIMBERLY A. DESTEFANO
  • NPI Number: 1447517578
  • Taxonomy: 310400000X - Assisted Living Facility

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CLIA Record

Field Name Field Value
CLIA Number 45D1101783
LAB Type Physician Office
Facility Name NORTH AUSTIN MATERNAL FETAL MEDICINE PLLC
Street 12200 RENFERT WAY SUITE G-3
City AUSTIN
State TX
ZIP 78758
Phone 512 821-2540
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/6/2025
Certificate Expiration Date 7/5/2027
Facility Type Physician Office
Lab Director KIMBERLY A. DESTEFANO

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