45D2003680 CLIA NUMBER - CEDAR PARK PHYSICIAN ASSOCIATES - AVERY RANCH

Laboratory Demographics

  • CLIA Code: 45D2003680
  • Facility Name: CEDAR PARK PHYSICIAN ASSOCIATES - AVERY RANCH
  • Facility Address: 15004 AVERY RANCH BLVD, STE 105
    AUSTIN, TX
    ZIP 78717
  • Facility Phone: 512 528-7401
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RONALD MCGAUGH
  • NPI Number: 1720344500
  • Taxonomy: 2083X0100X - Preventive Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D2003680
LAB Type Physician Office
Facility Name CEDAR PARK PHYSICIAN ASSOCIATES - AVERY RANCH
Street 15004 AVERY RANCH BLVD, STE 105
City AUSTIN
State TX
ZIP 78717
Phone 512 528-7401
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/17/2024
Certificate Expiration Date 2/16/2026
Facility Type Physician Office
Lab Director RONALD MCGAUGH

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