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45D2123850 CLIA NUMBER - PEDIATRIC UROLOGY OF CENTRAL TEXAS

Laboratory Demographics

CLIA Number: 45D2123850

Facility Name: PEDIATRIC UROLOGY OF CENTRAL TEXAS

Facility Address:
1301 MEDICAL PKWY STE 310
CEDAR PARK, TX
ZIP 78613
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Facility Phone Number: 512 472-6134

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1508932112

Taxonomy: 2088P0231X - Urology
Surgeons who can diagnose, treat, and manage children's urinary and genital problems. A pediatric urologist devotes a minimum of 50% of his or her practice to the urologic problems of infants, children, and adolescents. Pediatric urologists generally provide the following services: the evaluation and management of voiding disorders; vesicoureteral reflux, and urinary tract infections that require surgery; surgical reconstruction of the urinary tract (kidneys, ureters, and bladder) including genital abnormalities, hypospadias, and intersex conditions; surgery for groin conditions in childhood and adolescence (undescended testes, hydrocele/hernia, varicocele).

CLIA Record

Field Name Field Value
CLIA Number 45D2123850
LAB Type Physician Office
Facility Name PEDIATRIC UROLOGY OF CENTRAL TEXAS
Street 1301 MEDICAL PKWY STE 310
City CEDAR PARK
State TX
ZIP 78613
Phone 512 472-6134
CertificateType 4
CertificateEffectiveDate 1/4/2023
CertificateExpirationDate 1/3/2025
FacilityType Waiver

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This page was last updated on: 4/23/2024