37D1053573 CLIA NUMBER - NORTHEASTERN TRIBAL HEALTH CENTER PHARMACY

Laboratory Demographics

  • CLIA Code: 37D1053573
  • Facility Name: NORTHEASTERN TRIBAL HEALTH CENTER PHARMACY
  • Facility Address: 7600 SOUTH HIGHWAY 69A
    MIAMI, OK
    ZIP 74354
  • Facility Phone: 918 542-1741
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: GARY ELAM
  • NPI Number: 1871522532
  • Taxonomy: 261Q00000X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 37D1053573
LAB Type Pharmacy
Facility Name NORTHEASTERN TRIBAL HEALTH CENTER PHARMACY
Street 7600 SOUTH HIGHWAY 69A
City MIAMI
State OK
ZIP 74354
Phone 918 542-1741
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/27/2024
Certificate Expiration Date 4/26/2026
Facility Type Pharmacy
Lab Director GARY ELAM

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