37D0693641 CLIA NUMBER - SURGERY CENTER OF OKLAHOMA

Laboratory Demographics

CLIA Number: 37D0693641

Facility Name: SURGERY CENTER OF OKLAHOMA

Facility Address:
9500 N BROADWAY EXTENSION
OKLAHOMA CITY, OK
ZIP 73114
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Facility Phone Number: 405 475-0600

Facility Type: Ambulatory Surgery Center

Certificate Type: Waiver

NPI Number: 1124158704

Taxonomy: 261QA1903X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	37D0693641
LAB Type	Ambulatory Surgery Center
Facility Name	SURGERY CENTER OF OKLAHOMA
Street	9500 N BROADWAY EXTENSION
City	OKLAHOMA CITY
State	OK
ZIP	73114
Phone	405 475-0600
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