37D1035190 CLIA NUMBER - SOUTHCREST DIALYSIS LLC DBA SOUTHCREST

Laboratory Demographics

  • CLIA Code: 37D1035190
  • Facility Name: SOUTHCREST DIALYSIS LLC DBA SOUTHCREST
  • Facility Address: 10921 EAST 81ST STREET
    TULSA, OK
    ZIP 74133
  • Facility Phone: 918 249-8402
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: JANET RUSSELL
  • NPI Number: 1205816048
  • Taxonomy: 207PE0004X - Emergency Medicine

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CLIA Record

Field Name Field Value
CLIA Number 37D1035190
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name SOUTHCREST DIALYSIS LLC DBA SOUTHCREST
Street 10921 EAST 81ST STREET
City TULSA
State OK
ZIP 74133
Phone 918 249-8402
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/23/2024
Certificate Expiration Date 12/22/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director JANET RUSSELL

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