45D2154278 CLIA NUMBER - WISEMAN FAMILY PRACTICE, PLLC

Laboratory Demographics

  • CLIA Code: 45D2154278
  • Facility Name: WISEMAN FAMILY PRACTICE, PLLC
  • Facility Address: 2911 MEDICAL ARTS STE 1B
    AUSTIN, TX
    ZIP 78705
  • Facility Phone: 512 345-8970
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JEREMY D. WISEMAN
  • NPI Number: 1598195042
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D2154278
LAB Type Physician Office
Facility Name WISEMAN FAMILY PRACTICE, PLLC
Street 2911 MEDICAL ARTS STE 1B
City AUSTIN
State TX
ZIP 78705
Phone 512 345-8970
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/10/2024
Certificate Expiration Date 9/9/2026
Facility Type Physician Office
Lab Director JEREMY D. WISEMAN

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