04D2129139 CLIA NUMBER - UROLOGY GROUP, THE

Laboratory Demographics

  • CLIA Code: 04D2129139
  • Facility Name: UROLOGY GROUP, THE
  • Facility Address: 302 S RHODES STREET
    WEST MEMPHIS, AR
    ZIP 72301
  • Facility Phone: 901 767-8158
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DR. ANNE M. JORDAN
  • NPI Number: 1053346064
  • Taxonomy: 208800000X - Urology

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CLIA Record

Field Name Field Value
CLIA Number 04D2129139
LAB Type Physician Office
Facility Name UROLOGY GROUP, THE
Street 302 S RHODES STREET
City WEST MEMPHIS
State AR
ZIP 72301
Phone 901 767-8158
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/13/2025
Certificate Expiration Date 4/12/2027
Facility Type Physician Office
Lab Director DR. ANNE M. JORDAN

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