45D2248088 CLIA NUMBER - CH OLTORF LLC

Laboratory Demographics

  • CLIA Code: 45D2248088
  • Facility Name: CH OLTORF LLC
  • Facility Address: 2121 E OLTORF ST, SUITE 17A
    AUSTIN, TX
    ZIP 78741
  • Facility Phone: 512 351-9875
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOSHUA ALLEN
  • NPI Number: 1417539453
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 45D2248088
LAB Type Physician Office
Facility Name CH OLTORF LLC
Street 2121 E OLTORF ST, SUITE 17A
City AUSTIN
State TX
ZIP 78741
Phone 512 351-9875
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/11/2024
Certificate Expiration Date 1/10/2026
Facility Type Physician Office
Lab Director JOSHUA ALLEN

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