37D0880110 CLIA NUMBER - EASTGATE VILLAGE CARE & REHAB CENTER

Laboratory Demographics

  • CLIA Code: 37D0880110
  • Facility Name: EASTGATE VILLAGE CARE & REHAB CENTER
  • Facility Address: 3500 HASKELL BLVD
    MUSKOGEE, OK
    ZIP 74403
  • Facility Phone: 918 682-3191
  • Facility Type: Skilled Nursing Facility/Nursing Facility
  • Facility Type: Waiver
  • Lab Director: THERSA J. BYFIELD
  • NPI Number: 1083663512
  • Taxonomy: 314000000X - Skilled Nursing Facility

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CLIA Record

Field Name Field Value
CLIA Number 37D0880110
LAB Type Skilled Nursing Facility/Nursing Facility
Facility Name EASTGATE VILLAGE CARE & REHAB CENTER
Street 3500 HASKELL BLVD
City MUSKOGEE
State OK
ZIP 74403
Phone 918 682-3191
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/7/2023
Certificate Expiration Date 12/6/2025
Facility Type Skilled Nursing Facility/Nursing Facility
Lab Director THERSA J. BYFIELD

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