37D0474172 CLIA NUMBER - OU PHYSICIANS TULSA INTERNAL MEDICINE SCHUSTERMAN CENTER CLINIC

Laboratory Demographics

CLIA Number: 37D0474172

Facility Name: OU PHYSICIANS TULSA INTERNAL MEDICINE SCHUSTERMAN CENTER CLINIC

Facility Address:
4444 E 41ST STREET, 3RD FLOOR, STE A ATTN VICKIE MINTON
TULSA, OK
ZIP 74135
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Facility Phone Number: 918 619-4101

Facility Type: Community Clinic

Certificate Type: Waiver

NPI Number: 1518004829

Taxonomy: 261QM1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	37D0474172
LAB Type	Community Clinic
Facility Name	OU PHYSICIANS TULSA INTERNAL MEDICINE SCHUSTERMAN CENTER CLINIC
Street	4444 E 41ST STREET, 3RD FLOOR, STE A ATTN VICKIE MINTON
City	TULSA
State	OK
ZIP	74135
Phone	918 619-4101
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024