45D2130042 CLIA NUMBER - BURNING TREE LODGE

Laboratory Demographics

  • CLIA Code: 45D2130042
  • Facility Name: BURNING TREE LODGE
  • Facility Address: 122 FISHER ST
    ELGIN, TX
    ZIP 78621
  • Facility Phone: 512 285-5900
  • Facility Type: Other - SUBSTANCE ABUSE FACILITY
  • Facility Type: Waiver
  • Lab Director: CARLOS TRIRADO
  • NPI Number: 1396090403
  • Taxonomy: 324500000X - Substance Abuse Rehabilitation Facility

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CLIA Record

Field Name Field Value
CLIA Number 45D2130042
LAB Type Other - SUBSTANCE ABUSE FACILITY
Facility Name BURNING TREE LODGE
Street 122 FISHER ST
City ELGIN
State TX
ZIP 78621
Phone 512 285-5900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/1/2025
Certificate Expiration Date 4/30/2027
Facility Type Other - SUBSTANCE ABUSE FACILITY
Lab Director CARLOS TRIRADO

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