37D0958766 CLIA NUMBER - INTERNAL MEDICINE CLINIC, PLLC

Laboratory Demographics

  • CLIA Code: 37D0958766
  • Facility Name: INTERNAL MEDICINE CLINIC, PLLC
  • Facility Address: 410 NE 12TH STREET
    GUYMON, OK
    ZIP 73942
  • Facility Phone: 580 338-5500
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JEFFREY J. LIM
  • NPI Number: 1164541900
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 37D0958766
LAB Type Physician Office
Facility Name INTERNAL MEDICINE CLINIC, PLLC
Street 410 NE 12TH STREET
City GUYMON
State OK
ZIP 73942
Phone 580 338-5500
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/10/2025
Certificate Expiration Date 8/9/2027
Facility Type Physician Office
Lab Director JEFFREY J. LIM

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