45D2307035 CLIA NUMBER - PROFOUND HOSPICE CARE, LLC

Laboratory Demographics

  • CLIA Code: 45D2307035
  • Facility Name: PROFOUND HOSPICE CARE, LLC
  • Facility Address: 1309 RED STAG PL STE 1
    ROUND ROCK, TX
    ZIP 78665
  • Facility Phone: 734 604-7160
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: TINUOLA PATRICK-AYENI
  • NPI Number: 1750124822
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 45D2307035
LAB Type Hospice
Facility Name PROFOUND HOSPICE CARE, LLC
Street 1309 RED STAG PL STE 1
City ROUND ROCK
State TX
ZIP 78665
Phone 734 604-7160
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/28/2024
Certificate Expiration Date 6/27/2026
Facility Type Hospice
Lab Director TINUOLA PATRICK-AYENI

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