37D0997849 CLIA NUMBER - VILLAGE CENTER PEDIATRICS

Laboratory Demographics

  • CLIA Code: 37D0997849
  • Facility Name: VILLAGE CENTER PEDIATRICS
  • Facility Address: 2820 NORTH KELLY AVENUE, SUITE 200
    EDMOND, OK
    ZIP 73003
  • Facility Phone: 405 359-5900
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: TAMMY R. MASCHINO, MD
  • NPI Number: 1306160627
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 37D0997849
LAB Type Physician Office
Facility Name VILLAGE CENTER PEDIATRICS
Street 2820 NORTH KELLY AVENUE, SUITE 200
City EDMOND
State OK
ZIP 73003
Phone 405 359-5900
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/21/2025
Certificate Expiration Date 4/20/2027
Facility Type Physician Office
Lab Director TAMMY R. MASCHINO, MD

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