19D2222473 CLIA NUMBER - WK ADVANCED UROLOGY

Laboratory Demographics

  • CLIA Code: 19D2222473
  • Facility Name: WK ADVANCED UROLOGY
  • Facility Address: 2300 HOSPITAL DRIVE, SUITE 460
    BOSSIER CITY, LA
    ZIP 71111
  • Facility Phone: 318 212-7335
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: GERARD HENRY
  • NPI Number: 1922692813
  • Taxonomy: 208800000X - Urology

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CLIA Record

Field Name Field Value
CLIA Number 19D2222473
LAB Type Physician Office
Facility Name WK ADVANCED UROLOGY
Street 2300 HOSPITAL DRIVE, SUITE 460
City BOSSIER CITY
State LA
ZIP 71111
Phone 318 212-7335
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 4/29/2025
Certificate Expiration Date 4/28/2027
Facility Type Physician Office
Lab Director GERARD HENRY

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