37D1018374 CLIA NUMBER - GADUGI EMPLOYEE HEALTH CENTER CARE OF CHEROKEE NATION

Laboratory Demographics

CLIA Number: 37D1018374

Facility Name: GADUGI EMPLOYEE HEALTH CENTER CARE OF CHEROKEE NATION

Facility Address:
17611 S MUSKOGEE AVE
TAHLEQUAH, OK
ZIP 74464
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Facility Phone Number: 918 207-4911

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1093722324

Taxonomy: 261QM1300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	37D1018374
LAB Type	Physician Office
Facility Name	GADUGI EMPLOYEE HEALTH CENTER CARE OF CHEROKEE NATION
Street	17611 S MUSKOGEE AVE
City	TAHLEQUAH
State	OK
ZIP	74464
Phone	918 207-4911
CertificateType	4
CertificateEffectiveDate	10/21/2023
CertificateExpirationDate	10/20/2025
FacilityType	Waiver

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