18D0705827 CLIA NUMBER - FIRST UROLOGY, PSC

Laboratory Demographics

  • CLIA Code: 18D0705827
  • Facility Name: FIRST UROLOGY, PSC
  • Facility Address: 1023 NEW MOODY LANE, SUITE 202
    LA GRANGE, KY
    ZIP 40031
  • Facility Phone: 502 897-7172
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. M B. JACKSON
  • NPI Number: 1760749956
  • Taxonomy: 208800000X - Urology

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CLIA Record

Field Name Field Value
CLIA Number 18D0705827
LAB Type Physician Office
Facility Name FIRST UROLOGY, PSC
Street 1023 NEW MOODY LANE, SUITE 202
City LA GRANGE
State KY
ZIP 40031
Phone 502 897-7172
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 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Physician Office
Lab Director DR. M B. JACKSON

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