37D1011307 CLIA NUMBER - SAMANTHA JACKSON, MD PLLC

Laboratory Demographics

  • CLIA Code: 37D1011307
  • Facility Name: SAMANTHA JACKSON, MD PLLC
  • Facility Address: 415 W FOREST LANE
    HOBART, OK
    ZIP 73651
  • Facility Phone: 580 726-2226
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SAMANTHA L. JACKSON
  • NPI Number: 1104806967
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 37D1011307
LAB Type Physician Office
Facility Name SAMANTHA JACKSON, MD PLLC
Street 415 W FOREST LANE
City HOBART
State OK
ZIP 73651
Phone 580 726-2226
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/7/2025
Certificate Expiration Date 4/6/2027
Facility Type Physician Office
Lab Director SAMANTHA L. JACKSON

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