37D0961692 CLIA NUMBER - GOOD SHEPHERD HOSPICE

Laboratory Demographics

  • CLIA Code: 37D0961692
  • Facility Name: GOOD SHEPHERD HOSPICE
  • Facility Address: 7645 E 63RD STREET TRIAD II BLDG SUITE 200
    TULSA, OK
    ZIP 74133
  • Facility Phone: 918 743-5067
  • Facility Type: Hospice
  • Facility Type: Waiver
  • Lab Director: MANDI WHITENACK
  • NPI Number: 1821190984
  • Taxonomy: 251G00000X - Hospice Care, Community Based

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CLIA Record

Field Name Field Value
CLIA Number 37D0961692
LAB Type Hospice
Facility Name GOOD SHEPHERD HOSPICE
Street 7645 E 63RD STREET TRIAD II BLDG SUITE 200
City TULSA
State OK
ZIP 74133
Phone 918 743-5067
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/14/2025
Certificate Expiration Date 6/13/2027
Facility Type Hospice
Lab Director MANDI WHITENACK

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