37D1014420 CLIA NUMBER - RENEE J RUSSELL MD, INC, PC

Laboratory Demographics

  • CLIA Code: 37D1014420
  • Facility Name: RENEE J RUSSELL MD, INC, PC
  • Facility Address: 1110 NEO LOOP
    GROVE, OK
    ZIP 74344
  • Facility Phone: 918 786-3100
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: RENEE J. RUSSELL, MD
  • NPI Number: 1245286921
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 37D1014420
LAB Type Physician Office
Facility Name RENEE J RUSSELL MD, INC, PC
Street 1110 NEO LOOP
City GROVE
State OK
ZIP 74344
Phone 918 786-3100
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/1/2025
Certificate Expiration Date 12/31/2026
Facility Type Physician Office
Lab Director RENEE J. RUSSELL, MD

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