37D1053611 CLIA NUMBER - CHARLES C CARTER MD DPH, PLLC

Laboratory Demographics

  • CLIA Code: 37D1053611
  • Facility Name: CHARLES C CARTER MD DPH, PLLC
  • Facility Address: 1015 E BROADWAY SUITE 102
    ALTUS, OK
    ZIP 73522
  • Facility Phone: 580 480-1600
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CHARLES C. CARTER
  • NPI Number: 1730129750
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 37D1053611
LAB Type Physician Office
Facility Name CHARLES C CARTER MD DPH, PLLC
Street 1015 E BROADWAY SUITE 102
City ALTUS
State OK
ZIP 73522
Phone 580 480-1600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/15/2024
Certificate Expiration Date 11/14/2026
Facility Type Physician Office
Lab Director CHARLES C. CARTER

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