37D1059561 CLIA NUMBER - GONCE COSMETIC SURGERY CENTER

Laboratory Demographics

  • CLIA Code: 37D1059561
  • Facility Name: GONCE COSMETIC SURGERY CENTER
  • Facility Address: 3333 NW 63RD ST, #250
    OKLAHOMA CITY, OK
    ZIP 73116
  • Facility Phone: 405 748-3636
  • Facility Type: Ambulatory Surgery Center
  • Facility Type: Waiver
  • Lab Director: MIKE E. GONCE
  • NPI Number: 1184685901
  • Taxonomy: 261QA1903X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 37D1059561
LAB Type Ambulatory Surgery Center
Facility Name GONCE COSMETIC SURGERY CENTER
Street 3333 NW 63RD ST, #250
City OKLAHOMA CITY
State OK
ZIP 73116
Phone 405 748-3636
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/3/2024
Certificate Expiration Date 10/2/2026
Facility Type Ambulatory Surgery Center
Lab Director MIKE E. GONCE

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This page was last updated on: 6/4/2025