37D1043563 CLIA NUMBER - CENTRAL OKLAHOMA JUVENILE CENTER

Laboratory Demographics

CLIA Number: 37D1043563

Facility Name: CENTRAL OKLAHOMA JUVENILE CENTER

Facility Address:
700 S 9TH
TECUMSEH, OK
ZIP 74873
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Facility Phone Number: 405 598-4172

Facility Type: Ambulance

Certificate Type: Microscopy

NPI Number: 1174714877

Taxonomy: 111N00000X - Chiropractor
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

CLIA Record

Field Name	Field Value
CLIA Number	37D1043563
LAB Type	Ambulance
Facility Name	CENTRAL OKLAHOMA JUVENILE CENTER
Street	700 S 9TH
City	TECUMSEH
State	OK
ZIP	74873
Phone	405 598-4172
CertificateType	3
CertificateEffectiveDate	7/27/2023
CertificateExpirationDate	7/26/2025
FacilityType	PPMP

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