45D2012824 CLIA NUMBER - VITAE CLINIC, INC

Laboratory Demographics

  • CLIA Code: 45D2012824
  • Facility Name: VITAE CLINIC, INC
  • Facility Address: 4201 MARATHON BLVD STE 300
    AUSTIN, TX
    ZIP 78756
  • Facility Phone: 512 458-6060
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JEREMY A. KALAMARIDES
  • NPI Number: 1053626168
  • Taxonomy: 207V00000X - Obstetrics & Gynecology

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CLIA Record

Field Name Field Value
CLIA Number 45D2012824
LAB Type Physician Office
Facility Name VITAE CLINIC, INC
Street 4201 MARATHON BLVD STE 300
City AUSTIN
State TX
ZIP 78756
Phone 512 458-6060
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 9/9/2024
Certificate Expiration Date 9/8/2026
Facility Type Physician Office
Lab Director JEREMY A. KALAMARIDES

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