NPIMap

Organization Active NPI

Department of State Health Services

Doing business as Department of State Health Services (DSHS) Central Lab

  • Clinical Medical Laboratory
  • Austin, TX
National Provider Identifier
1114931391
Registry record updated Mar 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
DEPARTMENT OF STATE HEALTH SERVICES
Doing business as
Department of State Health Services (DSHS) Central Lab
Practice address
1100 W 49TH St
Austin, TX 78756-3101
Phone
(512) 458-7111
Fax
(512) 458-7588
NPI assigned
Jul 27, 2006
Last updated
Mar 12, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Grace Kubin
Title
Laboratory Director
Phone
(512) 776-2468

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X TX Primary

Addresses

Primary practice location

1100 W 49TH St
Austin, TX 78756-3101

Mailing address

PO Box 149347
DSHS- Central Lab/Zz320/MC 2004
Austin, TX 78714-9347
Phone (512) 458-7111

Other identifiers 2

IdentifierTypeStateIssuer
0254062-01MedicaidTX
CL1119OtherTXMEDICARE PTAN (PROVIDER TRANSACTION ACCESS NUMBER)

Other names 1

  • Department of State Health Services (DSHS) Central Lab Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110809000574 TX Part B Supplier - Independent Clinical Laboratory 6608784103 1 other NPI on this enrollment
Practice locations: Austin, TX; Harlingen, TX

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D0660644Laboratory Services Section1100 W 49TH Street, Austin, TX 78756AccreditationAug 2, 2026

National Provider Directory

National Provider Directory
Tax ID family
Big Spring State Hospital17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773273600000",
    "number": "1114931391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 149347",
            "address_2": "DSHS- CENTRAL LAB/ZZ320/MC 2004",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787149347",
            "telephone_number": "512-458-7111",
            "fax_number": "512-458-7588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 W 49TH ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787563101",
            "telephone_number": "512-458-7111",
            "fax_number": "512-458-7588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEPARTMENT OF STATE HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-27",
        "last_updated": "2026-03-12",
        "certification_date": "2026-03-12",
        "status": "A",
        "authorized_official_last_name": "KUBIN",
        "authorized_official_first_name": "GRACE",
        "authorized_official_title_or_position": "LABORATORY DIRECTOR",
        "authorized_official_telephone_number": "512-776-2468"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0254062-01",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN (PROVIDER TRANSACTION ACCESS NUMBER)",
            "identifier": "CL1119",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Department of State Health Services (DSHS) Central Lab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.