37D0671062 CLIA NUMBER - FOUNTAIN VIEW MANOR

Laboratory Demographics

  • CLIA Code: 37D0671062
  • Facility Name: FOUNTAIN VIEW MANOR
  • Facility Address: 107 E BARCLAY
    HENRYETTA, OK
    ZIP 74437
  • Facility Phone: 918 230-5465
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: JENNIFER M. MUNHOLLAND
  • NPI Number: 1124026448
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 37D0671062
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name FOUNTAIN VIEW MANOR
Street 107 E BARCLAY
City HENRYETTA
State OK
ZIP 74437
Phone 918 230-5465
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2024
Certificate Expiration Date 8/31/2026
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director JENNIFER M. MUNHOLLAND

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