10D2316454 CLIA NUMBER - PRODY UROLOGY, PLLC

Laboratory Demographics

  • CLIA Code: 10D2316454
  • Facility Name: PRODY UROLOGY, PLLC
  • Facility Address: 575 S WICKHAM RD, STE B
    WEST MELBOURNE, FL
    ZIP 32904
  • Facility Phone: 321 308-5060
  • Facility Type: Physician Office
  • Facility Type: Accreditation
  • Lab Director: VENUS DOOKWAH-ROBERTS
  • NPI Number: 1578028197
  • Taxonomy: 208800000X - Urology

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CLIA Record

Field Name Field Value
CLIA Number 10D2316454
LAB Type Physician Office
Facility Name PRODY UROLOGY, PLLC
Street 575 S WICKHAM RD, STE B
City WEST MELBOURNE
State FL
ZIP 32904
Phone 321 308-5060
Certificate Type Certificate of Accreditation
Certificate Type Description This is a certificate that is issued to a laboratory on the basis of the laboratory's accreditation by an accreditation organization approved by CMS.
Certificate Effective Date 1/6/2025
Certificate Expiration Date 1/5/2027
Facility Type Physician Office
Lab Director VENUS DOOKWAH-ROBERTS

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This page was last updated on: 6/4/2025