37D0469542 CLIA NUMBER - KELLEY FAMILY CLINIC

Laboratory Demographics

  • CLIA Code: 37D0469542
  • Facility Name: KELLEY FAMILY CLINIC
  • Facility Address: 13190 NE 23RD ST
    CHOCTAW, OK
    ZIP 73020
  • Facility Phone: 405 769-7201
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: STANLEY C. SHADID
  • NPI Number: 1689768285
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 37D0469542
LAB Type Physician Office
Facility Name KELLEY FAMILY CLINIC
Street 13190 NE 23RD ST
City CHOCTAW
State OK
ZIP 73020
Phone 405 769-7201
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/6/2025
Certificate Expiration Date 6/5/2027
Facility Type Physician Office
Lab Director STANLEY C. SHADID

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