37D0952471 CLIA NUMBER - GRAND LAKE OBSTERICS AND GYNECOLOGY

Laboratory Demographics

  • CLIA Code: 37D0952471
  • Facility Name: GRAND LAKE OBSTERICS AND GYNECOLOGY
  • Facility Address: 900 EAST 13TH SUITE 205
    GROVE, OK
    ZIP 74344
  • Facility Phone: 918 541-0826
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: ASHLEY SHELLEY
  • NPI Number: 1184684011
  • Taxonomy: 2085R0202X - Radiology

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CLIA Record

Field Name Field Value
CLIA Number 37D0952471
LAB Type Physician Office
Facility Name GRAND LAKE OBSTERICS AND GYNECOLOGY
Street 900 EAST 13TH SUITE 205
City GROVE
State OK
ZIP 74344
Phone 918 541-0826
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 10/14/2024
Certificate Expiration Date 10/13/2026
Facility Type Physician Office
Lab Director ASHLEY SHELLEY

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