37D1010290 CLIA NUMBER - UTICA PARK CLINIC

Laboratory Demographics

  • CLIA Code: 37D1010290
  • Facility Name: UTICA PARK CLINIC
  • Facility Address: 1245 S UTICA 203
    TULSA, OK
    ZIP 74104
  • Facility Phone: 918 579-8666
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: THOMAS DANIEL MIHELICH
  • NPI Number: 1235182775
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 37D1010290
LAB Type Physician Office
Facility Name UTICA PARK CLINIC
Street 1245 S UTICA 203
City TULSA
State OK
ZIP 74104
Phone 918 579-8666
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/11/2025
Certificate Expiration Date 3/10/2027
Facility Type Physician Office
Lab Director THOMAS DANIEL MIHELICH

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