37D0473158 CLIA NUMBER - OSU MEDICINE CLEVELAND

Laboratory Demographics

  • CLIA Code: 37D0473158
  • Facility Name: OSU MEDICINE CLEVELAND
  • Facility Address: 119 SOUTH BROADWAY
    CLEVELAND, OK
    ZIP 74020
  • Facility Phone: 918 358-2592
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PERRY W. EVANS JR
  • NPI Number: 1942281688
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 37D0473158
LAB Type Physician Office
Facility Name OSU MEDICINE CLEVELAND
Street 119 SOUTH BROADWAY
City CLEVELAND
State OK
ZIP 74020
Phone 918 358-2592
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/24/2025
Certificate Expiration Date 4/23/2027
Facility Type Physician Office
Lab Director PERRY W. EVANS JR

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