37D0892463 CLIA NUMBER - FAMILY MEDICAL CLINIC OF WESTERN OKLAHOMA

Laboratory Demographics

  • CLIA Code: 37D0892463
  • Facility Name: FAMILY MEDICAL CLINIC OF WESTERN OKLAHOMA
  • Facility Address: 411 NORTH RANDALL
    ELK CITY, OK
    ZIP 73644
  • Facility Phone: (580) 243-2273
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: ERICK C. DEROCHER, DO
  • NPI Number: 1316039688
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 37D0892463
LAB Type Physician Office
Facility Name FAMILY MEDICAL CLINIC OF WESTERN OKLAHOMA
Street 411 NORTH RANDALL
City ELK CITY
State OK
ZIP 73644
Phone 5802432273
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/29/2024
Certificate Expiration Date 9/28/2026
Facility Type Physician Office
Lab Director ERICK C. DEROCHER, DO

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This page was last updated on: 5/18/2026