37D0469907 CLIA NUMBER - CHARLES L LACKEY MD

Laboratory Demographics

  • CLIA Code: 37D0469907
  • Facility Name: CHARLES L LACKEY MD
  • Facility Address: 1515 N PORTER SUITE #200
    NORMAN, OK
    ZIP 73071
  • Facility Phone: 405 366-8619
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CHARLES L. LACKEY
  • NPI Number: 1285625640
  • Taxonomy: 207RG0100X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 37D0469907
LAB Type Physician Office
Facility Name CHARLES L LACKEY MD
Street 1515 N PORTER SUITE #200
City NORMAN
State OK
ZIP 73071
Phone 405 366-8619
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/20/2025
Certificate Expiration Date 3/19/2027
Facility Type Physician Office
Lab Director CHARLES L. LACKEY

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