45D2045475 CLIA NUMBER - PRO CARE SPINE CENTER, PLLC D/B/A PRO CARE MEDICAL CENTER

Laboratory Demographics

  • CLIA Code: 45D2045475
  • Facility Name: PRO CARE SPINE CENTER, PLLC D/B/A PRO CARE MEDICAL CENTER
  • Facility Address: 1015 W 39 1/2 STREET
    AUSTIN, TX
    ZIP 78756
  • Facility Phone: 512 371-7478
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOHNNY L. WHITE
  • NPI Number: 1396829222
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D2045475
LAB Type Physician Office
Facility Name PRO CARE SPINE CENTER, PLLC D/B/A PRO CARE MEDICAL CENTER
Street 1015 W 39 1/2 STREET
City AUSTIN
State TX
ZIP 78756
Phone 512 371-7478
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/14/2024
Certificate Expiration Date 8/13/2026
Facility Type Physician Office
Lab Director JOHNNY L. WHITE

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