37D0710913 CLIA NUMBER - CHOCTAW NATION HEALTH CLINIC

Laboratory Demographics

CLIA Number: 37D0710913

Facility Name: CHOCTAW NATION HEALTH CLINIC

Facility Address:
1300 MARTIN LUTHER KING DRIVE
BROKEN BOW, OK
ZIP 74728
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Facility Phone Number: 580 584-2740

Facility Type: Rural Health Clinic

Certificate Type: Accreditation

NPI Number: 1770559619

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	37D0710913
LAB Type	Rural Health Clinic
Facility Name	CHOCTAW NATION HEALTH CLINIC
Street	1300 MARTIN LUTHER KING DRIVE
City	BROKEN BOW
State	OK
ZIP	74728
Phone	580 584-2740
CertificateType	1
CertificateEffectiveDate	3/30/2024
CertificateExpirationDate	3/29/2026
FacilityType	Accreditation

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This page was last updated on: 4/23/2024