45D2007605 CLIA NUMBER - NORTH TEXAS UROLOGY

Laboratory Demographics

  • CLIA Code: 45D2007605
  • Facility Name: NORTH TEXAS UROLOGY
  • Facility Address: 2821 E PRESIDENT GEORGE BUSH HWY, SUITE 305
    RICHARDSON, TX
    ZIP 75082
  • Facility Phone: 972 235-3248
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: DR. RAVI K. MOOTHA
  • NPI Number: 1063653376
  • Taxonomy: 208800000X - Urology

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CLIA Record

Field Name Field Value
CLIA Number 45D2007605
LAB Type Physician Office
Facility Name NORTH TEXAS UROLOGY
Street 2821 E PRESIDENT GEORGE BUSH HWY, SUITE 305
City RICHARDSON
State TX
ZIP 75082
Phone 972 235-3248
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 4/17/2025
Certificate Expiration Date 4/16/2027
Facility Type Physician Office
Lab Director DR. RAVI K. MOOTHA

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