45D2167434 CLIA NUMBER - GLOWWORM PEDIATRICS

Laboratory Demographics

  • CLIA Code: 45D2167434
  • Facility Name: GLOWWORM PEDIATRICS
  • Facility Address: 2100 MUIRFIELD BEND DR. # 115
    HUTTO, TX
    ZIP 78634
  • Facility Phone: 512 861-9327
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: VU (ANTHONY) NGUYEN
  • NPI Number: 1285299461
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 45D2167434
LAB Type Physician Office
Facility Name GLOWWORM PEDIATRICS
Street 2100 MUIRFIELD BEND DR. # 115
City HUTTO
State TX
ZIP 78634
Phone 512 861-9327
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/7/2025
Certificate Expiration Date 6/6/2027
Facility Type Physician Office
Lab Director VU (ANTHONY) NGUYEN

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