19D2132745 CLIA NUMBER - WK PELVIC & RECONSTRUCTIVE GYN SURGERY

Laboratory Demographics

  • CLIA Code: 19D2132745
  • Facility Name: WK PELVIC & RECONSTRUCTIVE GYN SURGERY
  • Facility Address: 8001 YOUREE DRIVE, SUITE 370
    SHREVEPORT, LA
    ZIP 71115
  • Facility Phone: 318 212-3680
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: ANTONIO R. PIZARRO
  • NPI Number: 1598290249
  • Taxonomy: 2088F0040X - Urology

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CLIA Record

Field Name Field Value
CLIA Number 19D2132745
LAB Type Physician Office
Facility Name WK PELVIC & RECONSTRUCTIVE GYN SURGERY
Street 8001 YOUREE DRIVE, SUITE 370
City SHREVEPORT
State LA
ZIP 71115
Phone 318 212-3680
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 6/27/2025
Certificate Expiration Date 6/26/2027
Facility Type Physician Office
Lab Director ANTONIO R. PIZARRO

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