37D1000665 CLIA NUMBER - PONCA CITY IMMEDIATE CARE, LLC

Laboratory Demographics

CLIA Number: 37D1000665

Facility Name: PONCA CITY IMMEDIATE CARE, LLC

Facility Address:
1201 E HARTFORD ATTN VERONICA
PONCA CITY, OK
ZIP 74601
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Facility Phone Number: 580 762-1911

Facility Type: Physician Office

Certificate Type: Accreditation

NPI Number: 1740837889

Taxonomy: 207Q00000X - Family Medicine
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

CLIA Record

Field Name	Field Value
CLIA Number	37D1000665
LAB Type	Physician Office
Facility Name	PONCA CITY IMMEDIATE CARE, LLC
Street	1201 E HARTFORD ATTN VERONICA
City	PONCA CITY
State	OK
ZIP	74601
Phone	580 762-1911
CertificateType	1
CertificateEffectiveDate	5/22/2023
CertificateExpirationDate	5/21/2025
FacilityType	Accreditation

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This page was last updated on: 4/23/2024