45D2224370 CLIA NUMBER - PEACH STATE MEDICAL PRATICE DBA KINDBODY OF TEXAS MEDICAL PRATICE

Laboratory Demographics

CLIA Number: 45D2224370

Facility Name: PEACH STATE MEDICAL PRATICE DBA KINDBODY OF TEXAS MEDICAL PRATICE

Facility Address:
100 COLORADO STREET
AUSTIN, TX
ZIP 78701
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Facility Phone Number: 737 787-7806

Facility Type: Physician Office

Certificate Type: Accreditation

NPI Number: 1083295638

Taxonomy: 261QA0006X - Clinic/Center
A fertility facility, which may be licensed, registered, or certified in some states, that is not hospital-based, where services are provided at a fixed specific location. An Ambulatory Fertility Facility does not provide overnight accommodations. The following fertility procedures may be performed at an Ambulatory Fertility Facility: In Vitro Fertilization (IVF), Gamete Intrafallopian Transfer (GIFT), Embryo Transfer-Thaw (ET-T), Zygote Intrafallopian Transfer (ZIFT), Donor OOCYTE (DO)

CLIA Record

Field Name	Field Value
CLIA Number	45D2224370
LAB Type	Physician Office
Facility Name	PEACH STATE MEDICAL PRATICE DBA KINDBODY OF TEXAS MEDICAL PRATICE
Street	100 COLORADO STREET
City	AUSTIN
State	TX
ZIP	78701
Phone	737 787-7806
CertificateType	1
CertificateEffectiveDate	7/13/2022
CertificateExpirationDate	7/12/2024
FacilityType	Accreditation

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