45D2285976 CLIA NUMBER - MED SOUTHWEST, PLLC

Laboratory Demographics

  • CLIA Code: 45D2285976
  • Facility Name: MED SOUTHWEST, PLLC
  • Facility Address: 15004 AVERY RANCH BLVD, STE 103
    AUSTIN, TX
    ZIP 78717
  • Facility Phone: 707 847-8899
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JOSEPH KAVANAGH
  • NPI Number: 1669116687
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 45D2285976
LAB Type Physician Office
Facility Name MED SOUTHWEST, PLLC
Street 15004 AVERY RANCH BLVD, STE 103
City AUSTIN
State TX
ZIP 78717
Phone 707 847-8899
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/20/2025
Certificate Expiration Date 7/19/2027
Facility Type Physician Office
Lab Director JOSEPH KAVANAGH

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