45D1103683 CLIA NUMBER - AUSTIN LIFECARE DBA THE SOURCE

Laboratory Demographics

  • CLIA Code: 45D1103683
  • Facility Name: AUSTIN LIFECARE DBA THE SOURCE
  • Facility Address: 1007 E 41ST ST
    AUSTIN, TX
    ZIP 78751
  • Facility Phone: 512 374-0055
  • Facility Type: Practitioner Other
  • Facility Type: Microscopy
  • Lab Director: ERIN J. STIBRAL
  • NPI Number: 1922593250
  • Taxonomy: 261QM1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 45D1103683
LAB Type Practitioner Other
Facility Name AUSTIN LIFECARE DBA THE SOURCE
Street 1007 E 41ST ST
City AUSTIN
State TX
ZIP 78751
Phone 512 374-0055
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/6/2025
Certificate Expiration Date 9/5/2027
Facility Type Practitioner Other
Lab Director ERIN J. STIBRAL

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