37D1044356 CLIA NUMBER - IDABEL CHILDRENS CLINIC

Laboratory Demographics

  • CLIA Code: 37D1044356
  • Facility Name: IDABEL CHILDRENS CLINIC
  • Facility Address: 1307 S LYNN LANE
    IDABEL, OK
    ZIP 74745
  • Facility Phone: 580 286-5437
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARY BRADLEY LEBOEUF MD
  • NPI Number: 1689985343
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 37D1044356
LAB Type Physician Office
Facility Name IDABEL CHILDRENS CLINIC
Street 1307 S LYNN LANE
City IDABEL
State OK
ZIP 74745
Phone 580 286-5437
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/17/2025
Certificate Expiration Date 8/16/2027
Facility Type Physician Office
Lab Director MARY BRADLEY LEBOEUF MD

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