37D0706595 CLIA NUMBER - TAHLEQUAH DIALYSIS CENTER

Laboratory Demographics

  • CLIA Code: 37D0706595
  • Facility Name: TAHLEQUAH DIALYSIS CENTER
  • Facility Address: 1373 EAST BOONE STREET
    TAHLEQUAH, OK
    ZIP 74464
  • Facility Phone: 918 431-0665
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: BILAL AZIZ
  • NPI Number: 1346320322
  • Taxonomy: 251300000X - Local Education Agency (LEA)

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CLIA Record

Field Name Field Value
CLIA Number 37D0706595
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name TAHLEQUAH DIALYSIS CENTER
Street 1373 EAST BOONE STREET
City TAHLEQUAH
State OK
ZIP 74464
Phone 918 431-0665
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 End Stage Renal Disease Dialysis Facility
Lab Director BILAL AZIZ

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