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One-hour access was highest in the Northeast (84.2% of children, P.001) and lowest in the South (65.7%) and higher in states with the greatest urbanization in comparison with more rural states (85.1 vs 37.4%, P.001). Similar patterns were seen for access to 2 or more cleft centers. The number of CLP children-per-center was highest in the West (775) and lowest in the Northeast (452). Travel distances of more than 1hour may affect more than 25,000 (1 of 4) CLP children in the US, with significant variation across geographic regions. Future st