45D2186211 CLIA NUMBER - LAKE HILLS PHARMACY COMPOUNDING AND WELLNESS CENTER

Laboratory Demographics

  • CLIA Code: 45D2186211
  • Facility Name: LAKE HILLS PHARMACY COMPOUNDING AND WELLNESS CENTER
  • Facility Address: 12005 BEE CAVE ROAD 111-A
    AUSTIN, TX
    ZIP 78738
  • Facility Phone: 512 608-9355
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JOBBY JOHN
  • NPI Number: 1750778783
  • Taxonomy: 3336L0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 45D2186211
LAB Type Pharmacy
Facility Name LAKE HILLS PHARMACY COMPOUNDING AND WELLNESS CENTER
Street 12005 BEE CAVE ROAD 111-A
City AUSTIN
State TX
ZIP 78738
Phone 512 608-9355
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/15/2024
Certificate Expiration Date 6/14/2026
Facility Type Pharmacy
Lab Director JOBBY JOHN

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