37D1078745 CLIA NUMBER - IRVIN MEDICAL CLINIC

Laboratory Demographics

CLIA Number: 37D1078745

Facility Name: IRVIN MEDICAL CLINIC

Facility Address:
1001 E JACKSON ST
HUGO, OK
ZIP 74743
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Facility Phone Number: 580 317-9000

Facility Type: Physician Office

Certificate Type: Microscopy

NPI Number: 1215320320

Taxonomy: 261QP2300X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	37D1078745
LAB Type	Physician Office
Facility Name	IRVIN MEDICAL CLINIC
Street	1001 E JACKSON ST
City	HUGO
State	OK
ZIP	74743
Phone	580 317-9000
CertificateType	3
CertificateEffectiveDate	1/15/2024
CertificateExpirationDate	1/14/2026
FacilityType	PPMP

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This page was last updated on: 4/23/2024