37D0475409 CLIA NUMBER - PUSHMATAHA HOSPITAL

Laboratory Demographics

  • CLIA Code: 37D0475409
  • Facility Name: PUSHMATAHA HOSPITAL
  • Facility Address: 510 E MAIN ST
    ANTLERS, OK
    ZIP 74523
  • Facility Phone: 580 298-3341
  • Facility Type: Hospital
  • Facility Type: Certificate of Compliance
  • Lab Director: BRYCE BLISS
  • NPI Number: 1578587655
  • Taxonomy: 251E00000X - Home Health

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CLIA Record

Field Name Field Value
CLIA Number 37D0475409
LAB Type Hospital
Facility Name PUSHMATAHA HOSPITAL
Street 510 E MAIN ST
City ANTLERS
State OK
ZIP 74523
Phone 580 298-3341
Certificate Type Certificate of Compliance
Certificate Type Description This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.
Certificate Effective Date 4/20/2025
Certificate Expiration Date 4/19/2027
Facility Type Hospital
Lab Director BRYCE BLISS

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