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CENTERS FOR ADVANCED UROLOGY, LLC
NPI 1659947117
Non-Pharmacy Dispensing Site in Wake Forest, NC

Active since June 03, 2021CLIA 34D1088764 · Waiver
1904 S MAIN ST STE 114, WAKE FOREST, NC 27587(919) 390-3978 Get Directions Write a Review

NPPES record last updated: October 28, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Centers For Advanced Urology, Llc NPPES

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

CENTERS FOR ADVANCED UROLOGY, LLC (NPI 1659947117) is a healthcare organization registered as a non-pharmacy dispensing site in Wake Forest, North Carolina and active in the NPI registry since June 2021. The organization holds a CLIA Waiver certificate valid through May 14, 2027 and lists Joanie Marie Cochran, Credentialing Agent, as its authorized official.

NPPES Registry Identity

NPI1659947117
Entity TypeOrganization
Primary Taxonomy332900000X
Legal Business NameCENTERS FOR ADVANCED UROLOGY, LLC
Location Address1904 S MAIN ST STE 114Wake Forest, NC 27587-5030
Mailing Address1904 S Main St Ste 114Wake Forest, NC 27587-5030
Phone(919) 390-3978
Organization SubpartNo
Authorized OfficialJoanie Marie CochranCredentialing Agent · (336) 306-9755
Enumeration DateJune 3, 2021
Last NPPES UpdateOctober 28, 2025
NPPES CertifiedOctober 28, 2025
✔ NPI 1659947117 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNon-Pharmacy Dispensing SiteSuppliers
Taxonomy Code332900000X
Definition
A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)
1904 S MAIN ST STE 114, Wake Forest, NC 27587
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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 Waiver 34D1088764

Centers For Advanced Urology, LLP, The · Wake Forest, NC
Active · expires May 14, 2027
CLIA Number34D1088764
Laboratory TypePhysician Office
Certificate Effective DateMay 15, 2025
Certificate Expiration DateMay 14, 2027
Laboratory DirectorMark Jalkut
Laboratory Phone(919) 758-8677
Laboratory LocationCenters For Advanced Urology, LLP, The110 Capcom Avenue Suite 201, Wake Forest, NC 27587
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

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

DR. NORMAN J GOLDBACH MD
Urology
1904 S MAIN ST STE 114
WAKE FOREST, NC 27587
Wake County (919) 554-8539
MS. LISA GALEN KERR PA-C
Physician Assistant
1904 S MAIN ST STE 114
WAKE FOREST, NC 27587
Wake County (919) 758-8677

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 Centers For Advanced Urology, LLC's NPI number?

The NPI number for Centers For Advanced Urology, LLC is 1659947117. It was assigned to this organization in the NPPES registry on June 3, 2021.

Where is Centers For Advanced Urology, LLC located?

Centers For Advanced Urology, LLC is located at 1904 S Main St Ste 114, Wake Forest, NC 27587. The listed phone number is (919) 390-3978.

What is Centers For Advanced Urology, LLC's specialty?

The primary specialty registered for this NPI is Non-Pharmacy Dispensing Site with taxonomy code 332900000X.

Does Centers For Advanced Urology, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 34D1088764) is associated with this NPI, valid through May 14, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Centers For Advanced Urology, LLC was last updated on October 28, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.