15D1064941 CLIA NUMBER - UROLOGY GROUP CI, THE

Laboratory Demographics

  • CLIA Code: 15D1064941
  • Facility Name: UROLOGY GROUP CI, THE
  • Facility Address: 141 W 22ND ST STE 213
    ANDERSON, IN
    ZIP 46016
  • Facility Phone: 765 643-0766
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JEFFREY ULRICH
  • NPI Number: 1386826741
  • Taxonomy: 208800000X - Urology

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CLIA Record

Field Name Field Value
CLIA Number 15D1064941
LAB Type Physician Office
Facility Name UROLOGY GROUP CI, THE
Street 141 W 22ND ST STE 213
City ANDERSON
State IN
ZIP 46016
Phone 765 643-0766
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 2/16/2025
Certificate Expiration Date 2/15/2027
Facility Type Physician Office
Lab Director JEFFREY ULRICH

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