37D0884750 CLIA NUMBER - CITY OF COLLINSVILLE EMERG MED SERV

Laboratory Demographics

CLIA Number: 37D0884750

Facility Name: CITY OF COLLINSVILLE EMERG MED SERV

Facility Address:
1214 WEST MAIN
COLLINSVILLE, OK
ZIP 74021
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Facility Phone Number: 918 371-1031

Facility Type: Other

Certificate Type: Waiver

NPI Number: 1871647750

Taxonomy: 3416L0300X - Ambulance

CLIA Record

Field Name	Field Value
CLIA Number	37D0884750
LAB Type	Other
Facility Name	CITY OF COLLINSVILLE EMERG MED SERV
Street	1214 WEST MAIN
City	COLLINSVILLE
State	OK
ZIP	74021
Phone	918 371-1031
CertificateType	4
CertificateEffectiveDate	4/9/2024
CertificateExpirationDate	4/8/2026
FacilityType	Waiver

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