10D2160125 CLIA NUMBER - UROLOGIC INTEGRATED CARE LLC DBA UROLOGIC INTEGRATED CARE

Laboratory Demographics

CLIA Number: 10D2160125

Facility Name: UROLOGIC INTEGRATED CARE LLC DBA UROLOGIC INTEGRATED CARE

Facility Address:
1201 NW 64TH TER
GAINESVILLE, FL
ZIP 32605
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Facility Phone Number: 352 204-5400

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1104392232

Taxonomy: 208800000X - Urology
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

CLIA Record

Field Name	Field Value
CLIA Number	10D2160125
LAB Type	Physician Office
Facility Name	UROLOGIC INTEGRATED CARE LLC DBA UROLOGIC INTEGRATED CARE
Street	1201 NW 64TH TER
City	GAINESVILLE
State	FL
ZIP	32605
Phone	352 204-5400
CertificateType	4
CertificateEffectiveDate	1/4/2023
CertificateExpirationDate	1/3/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024