19D1061612 CLIA NUMBER - WEST JEFFERSON UROLOGY SPECIALISTS NEW ORLEANS PHYSICIANS SERVICES, INC

Laboratory Demographics

  • CLIA Code: 19D1061612
  • Facility Name: WEST JEFFERSON UROLOGY SPECIALISTS NEW ORLEANS PHYSICIANS SERVICES, INC
  • Facility Address: 1111 MEDICAL CENTER BLVD, NORTH TOWER, SUITE 703
    MARRERO, LA
    ZIP 70072
  • Facility Phone: 504 934-8100
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: JON R. GLASS
  • NPI Number: 1649575952
  • Taxonomy: 208800000X - Urology

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CLIA Record

Field Name Field Value
CLIA Number 19D1061612
LAB Type Physician Office
Facility Name WEST JEFFERSON UROLOGY SPECIALISTS NEW ORLEANS PHYSICIANS SERVICES, INC
Street 1111 MEDICAL CENTER BLVD, NORTH TOWER, SUITE 703
City MARRERO
State LA
ZIP 70072
Phone 504 934-8100
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 11/21/2024
Certificate Expiration Date 11/20/2026
Facility Type Physician Office
Lab Director JON R. GLASS

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