45D1104062 CLIA NUMBER - LONGHORN VILLAGE

Laboratory Demographics

  • CLIA Code: 45D1104062
  • Facility Name: LONGHORN VILLAGE
  • Facility Address: 12001 LONGHORN PARKWAY
    AUSTIN, TX
    ZIP 78732
  • Facility Phone: 512 384-4664
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: RUTH P. HICKS
  • NPI Number: 1700275898
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 45D1104062
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name LONGHORN VILLAGE
Street 12001 LONGHORN PARKWAY
City AUSTIN
State TX
ZIP 78732
Phone 512 384-4664
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/25/2025
Certificate Expiration Date 8/24/2027
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director RUTH P. HICKS

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