45D2082645 CLIA NUMBER - AUSTIN REGIONAL CLINIC AT WILSON PARKE

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Laboratory Demographics

CLIA Number: 45D2082645

Facility Name: AUSTIN REGIONAL CLINIC AT WILSON PARKE

Facility Address:
11714 WILSON PARKE AVE,STE 150
AUSTIN, TX
ZIP 78726
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Facility Phone Number: 512 465-1608

Facility Type: Physician Office

Certificate Type: Accreditation

NPI Number: 1275099764

Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

CLIA Record

Field Name	Field Value
CLIA Number	45D2082645
LAB Type	Physician Office
Facility Name	AUSTIN REGIONAL CLINIC AT WILSON PARKE
Street	11714 WILSON PARKE AVE,STE 150
City	AUSTIN
State	TX
ZIP	78726
Phone	512 465-1608
CertificateType	1
CertificateEffectiveDate	6/3/2023
CertificateExpirationDate	6/2/2025
FacilityType	Accreditation

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