37D0469916 CLIA NUMBER - PREMIERE PEDIATRICS

Laboratory Demographics

  • CLIA Code: 37D0469916
  • Facility Name: PREMIERE PEDIATRICS
  • Facility Address: 3261 24TH AVE NW SUITE 101
    NORMAN, OK
    ZIP 73069
  • Facility Phone: 405 364-6432
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BRIAN T. ELLIS
  • NPI Number: 1043354228
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 37D0469916
LAB Type Physician Office
Facility Name PREMIERE PEDIATRICS
Street 3261 24TH AVE NW SUITE 101
City NORMAN
State OK
ZIP 73069
Phone 405 364-6432
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/13/2024
Certificate Expiration Date 4/12/2026
Facility Type Physician Office
Lab Director BRIAN T. ELLIS

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