15D0857089 CLIA NUMBER - FIRST UROLOGY PSC

Laboratory Demographics

  • CLIA Code: 15D0857089
  • Facility Name: FIRST UROLOGY PSC
  • Facility Address: 313 FEDERAL DR NW STE 140
    CORYDON, IN
    ZIP 47112
  • Facility Phone: 812 282-3899
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: CHARLES J. GOODWIN
  • NPI Number: 1477810687
  • Taxonomy: 208800000X - Urology

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CLIA Record

Field Name Field Value
CLIA Number 15D0857089
LAB Type Physician Office
Facility Name FIRST UROLOGY PSC
Street 313 FEDERAL DR NW STE 140
City CORYDON
State IN
ZIP 47112
Phone 812 282-3899
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 6/21/2023
Certificate Expiration Date 6/20/2025
Facility Type Physician Office
Lab Director CHARLES J. GOODWIN

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This page was last updated on: 3/20/2025