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SOUTHERN UROLOGY LLC
NPI 1174232532
Urology in Lafayette, LA

Active since November 15, 2022CLIA 19D1106904 · Certificate of Compliance
120 RUE LOUIS XIV, BUILDING 1, LAFAYETTE, LA 70508(337) 769-7779 Get Directions Write a Review

NPPES record last updated: March 13, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Mar 13, 2023, Nov 21, 2022, Nov 15, 2022 (3 updates tracked since 2022).

About Southern Urology Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHERN UROLOGY LLC (NPI 1174232532) is a healthcare organization registered as an urology in Lafayette, Louisiana and active in the NPI registry since November 2022. The organization holds a CLIA Certificate of Compliance certificate valid through November 14, 2026 and lists Mark Robert Eldredge, Ao, as its authorized official.

NPPES Registry Identity

NPI1174232532
Entity TypeOrganization
Primary Taxonomy208800000X
Legal Business NameSOUTHERN UROLOGY LLC
Location Address120 RUE LOUIS XIV, BUILDING 1Lafayette, LA 70508-5739
Mailing Address120 Rue Louis XivLafayette, LA 70508-5739 · (337) 769-7779
Phone(337) 769-7779
Organization SubpartYes
Authorized OfficialMark Robert EldredgeAo · (337) 769-7779
Enumeration DateNovember 15, 2022
Last NPPES UpdateMarch 13, 20233 updates tracked since enumeration
NPPES CertifiedMarch 13, 2023
✔ NPI 1174232532 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians
Taxonomy Code208800000X
Definition

A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

120 RUE LOUIS XIV, Lafayette, LA 70508
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 19D1106904

Southern Urology · Lafayette, LA
Active · expires Nov 14, 2026
CLIA Number19D1106904
Laboratory TypePhysician Office
Certificate Effective DateNovember 15, 2024
Certificate Expiration DateNovember 14, 2026
Laboratory DirectorZoltan Gombos
Laboratory Phone(337) 422-3640
Laboratory LocationSouthern Urology120 Rue Louis Xiv Bldg #2, Attn Mike Fontenot, Lafayette, LA 70508
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JASON BOURQUE M.D.
Urology
120 RUE LOUIS XIV
LAFAYETTE, LA 70508
Lafayette Parish (337) 769-7779
DR. JAMES KYLE RUSSO II M.D.
Radiology (Radiation Oncology)
120 RUE LOUIS XIV
LAFAYETTE, LA 70508
Lafayette Parish (337) 769-7779
JESSICA CHAMPAGNE FNP
Nurse Practitioner (Family)
120 RUE LOUIS XIV
LAFAYETTE, LA 70508
Lafayette Parish (337) 233-6665
DR. ALAYNA DAUZAT DUNBAR MD
Urology
120 RUE LOUIS XIV
LAFAYETTE, LA 70508
Lafayette Parish (337) 233-6665
JACQUELINE HASTING FRYE APRN, FNP-C
Nurse Practitioner (Family)
120 RUE LOUIS XIV
LAFAYETTE, LA 70508
Lafayette Parish (337) 233-6665

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Southern Urology LLC's NPI number?

The NPI number for Southern Urology LLC is 1174232532. It was assigned to this organization in the NPPES registry on November 15, 2022.

Where is Southern Urology LLC located?

Southern Urology LLC is located at 120 Rue Louis Xiv Building 1, Lafayette, LA 70508. The listed phone number is (337) 769-7779.

What is Southern Urology LLC's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Does Southern Urology LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 19D1106904) is associated with this NPI, valid through November 14, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Southern Urology LLC was last updated on March 13, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.