37D0891192 CLIA NUMBER - OKMULGEE DIALYSIS CENTER

Laboratory Demographics

CLIA Number: 37D0891192

Facility Name: OKMULGEE DIALYSIS CENTER

Facility Address:
201 SOUTH DELAWARE AVENUE
OKMULGEE, OK
ZIP 74447
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Facility Phone Number: 918 756-3526

Facility Type: End Stage Renal Disease Dialysis Facility

Certificate Type: Waiver

NPI Number: 1609865666

Taxonomy: 207PE0004X - Emergency Medicine
An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients.

CLIA Record

Field Name	Field Value
CLIA Number	37D0891192
LAB Type	End Stage Renal Disease Dialysis Facility
Facility Name	OKMULGEE DIALYSIS CENTER
Street	201 SOUTH DELAWARE AVENUE
City	OKMULGEE
State	OK
ZIP	74447
Phone	918 756-3526
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