37D0685254 CLIA NUMBER - ASPEN CHILDREN'S CLINIC OF BROKEN ARROW

Laboratory Demographics

  • CLIA Code: 37D0685254
  • Facility Name: ASPEN CHILDREN'S CLINIC OF BROKEN ARROW
  • Facility Address: 3300 S ASPEN AVE, STE B
    BROKEN ARROW, OK
    ZIP 74012
  • Facility Phone: 918 455-4140
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SURESH BHARANI
  • NPI Number: 1144363094
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 37D0685254
LAB Type Physician Office
Facility Name ASPEN CHILDREN'S CLINIC OF BROKEN ARROW
Street 3300 S ASPEN AVE, STE B
City BROKEN ARROW
State OK
ZIP 74012
Phone 918 455-4140
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/13/2023
Certificate Expiration Date 7/12/2025
Facility Type Physician Office
Lab Director SURESH BHARANI

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This page was last updated on: 6/4/2025