37D0892289 CLIA NUMBER - UTICA PARK CLINIC FAMILY CARE

Laboratory Demographics

  • CLIA Code: 37D0892289
  • Facility Name: UTICA PARK CLINIC FAMILY CARE
  • Facility Address: 2403 WEST MAIN STREET
    HENRYETTA, OK
    ZIP 74437
  • Facility Phone: 918 652-9650
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ERIC MATHIS
  • NPI Number: 1871008722
  • Taxonomy: 261QR1300X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 37D0892289
LAB Type Physician Office
Facility Name UTICA PARK CLINIC FAMILY CARE
Street 2403 WEST MAIN STREET
City HENRYETTA
State OK
ZIP 74437
Phone 918 652-9650
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/27/2024
Certificate Expiration Date 9/26/2026
Facility Type Physician Office
Lab Director ERIC MATHIS

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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