37D0687191 CLIA NUMBER - BROKEN BOW HEALTH AND REHABILITATION, LLC DBA BROKEN BOW NURSING HOME

Laboratory Demographics

  • CLIA Code: 37D0687191
  • Facility Name: BROKEN BOW HEALTH AND REHABILITATION, LLC DBA BROKEN BOW NURSING HOME
  • Facility Address: 700 WEST JONES PO BOX 130
    BROKEN BOW, OK
    ZIP 74728
  • Facility Phone: 580 584-6433
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: BLANCHIE W. MIZE
  • NPI Number: 1811658685
  • Taxonomy: 261QD0000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 37D0687191
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name BROKEN BOW HEALTH AND REHABILITATION, LLC DBA BROKEN BOW NURSING HOME
Street 700 WEST JONES PO BOX 130
City BROKEN BOW
State OK
ZIP 74728
Phone 580 584-6433
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 BLANCHIE W. MIZE

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