Went in for a tire rotate and balance. Drove away and immediately started noticing a bit of vibration after 45mph.... Could this be a bad balance, and need rebalanced or should i look for the problem elsewhere?

Recheck the balance first. Also make sure lugs are properly secured.

I used to repair wheel balancers. You can't believe how many balancers out there are out of calibration. Get them rebalanced.

i have the same problem and it is ot the tires and i still havent found the problem. i think the problem is no load because these truck ride alot better with 500lb in the back

WEnt back intoday and told them what was happening. He sent his tech out to drive it, and he immediately noticed it and diagnosed the issue. It had a "hop" in the left front, he took the wheel off and rotated it on 180deg. and bolted it back on.... oddly enough rides smooth as a babies bottom. I dont know why but it works.

WEnt back intoday and told them what was happening. He sent his tech out to drive it, and he immediately noticed it and diagnosed the issue. It had a "hop" in the left front, he took the wheel off and rotated it on 180deg. and bolted it back on.... oddly enough rides smooth as a babies bottom. I dont know why but it works.
Wheel and tire out of roindness are not uncommon and can frequently be compensated for assembling the tire and wheel so that nthe out of roundness'es are placed oppisite each other. The better wheel balance machines detect that and tell the machine operator. Sometimes steel wheels are so bad they have to be replaced, tires also.