37D1045192 CLIA NUMBER - MICKEY TYRRELL MD, PLLC

Laboratory Demographics

  • CLIA Code: 37D1045192
  • Facility Name: MICKEY TYRRELL MD, PLLC
  • Facility Address: 803 N FOREMAN
    VINITA, OK
    ZIP 74301
  • Facility Phone: 918 256-2261
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MICKEY R. TYRRELL
  • NPI Number: 1710925680
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 37D1045192
LAB Type Physician Office
Facility Name MICKEY TYRRELL MD, PLLC
Street 803 N FOREMAN
City VINITA
State OK
ZIP 74301
Phone 918 256-2261
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/8/2025
Certificate Expiration Date 9/7/2027
Facility Type Physician Office
Lab Director MICKEY R. TYRRELL

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