45D2313256 CLIA NUMBER - LAKELINE OUTPATIENT CARE, PLLC

Laboratory Demographics

  • CLIA Code: 45D2313256
  • Facility Name: LAKELINE OUTPATIENT CARE, PLLC
  • Facility Address: 1860 S LAKELINE BLVD.
    CEDAR PARK, TX
    ZIP 78613
  • Facility Phone: 512 971-5928
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARC M. DANIEL
  • NPI Number: 1043482540
  • Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies

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CLIA Record

Field Name Field Value
CLIA Number 45D2313256
LAB Type Physician Office
Facility Name LAKELINE OUTPATIENT CARE, PLLC
Street 1860 S LAKELINE BLVD.
City CEDAR PARK
State TX
ZIP 78613
Phone 512 971-5928
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/28/2024
Certificate Expiration Date 10/27/2026
Facility Type Physician Office
Lab Director MARC M. DANIEL

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