45D2068344 CLIA NUMBER - NUCARA PHARMACY #17

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Laboratory Demographics

CLIA Number: 45D2068344

Facility Name: NUCARA PHARMACY #17

Facility Address:
6111 BURNET ROAD
AUSTIN, TX
ZIP 78757
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Facility Phone Number: 512 454-9923

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1063423614

Taxonomy: 251F00000X - Home Infusion

CLIA Record

Field Name	Field Value
CLIA Number	45D2068344
LAB Type	Pharmacy
Facility Name	NUCARA PHARMACY #17
Street	6111 BURNET ROAD
City	AUSTIN
State	TX
ZIP	78757
Phone	512 454-9923
CertificateType	4
CertificateEffectiveDate	11/1/2023
CertificateExpirationDate	10/31/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024