37D1012048 CLIA NUMBER - CARTER HEALTHCARE AND HOSPICE

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Laboratory Demographics

CLIA Number: 37D1012048

Facility Name: CARTER HEALTHCARE AND HOSPICE

Facility Address:
200 EAST HARRIS CIRCLE SUITE A
TAHLEQUAH, OK
ZIP 74464
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Facility Phone Number: 405 947-7700

Facility Type: Hospice

Certificate Type: Waiver

NPI Number: 1245347632

Taxonomy: 251G00000X - Hospice Care, Community Based

CLIA Record

Field Name	Field Value
CLIA Number	37D1012048
LAB Type	Hospice
Facility Name	CARTER HEALTHCARE AND HOSPICE
Street	200 EAST HARRIS CIRCLE SUITE A
City	TAHLEQUAH
State	OK
ZIP	74464
Phone	405 947-7700
CertificateType	4
CertificateEffectiveDate	4/30/2023
CertificateExpirationDate	4/29/2025
FacilityType	Waiver

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