37D1090196 CLIA NUMBER - PROVIDENCE FAMILY PRACTICE, PLLC

Laboratory Demographics

  • CLIA Code: 37D1090196
  • Facility Name: PROVIDENCE FAMILY PRACTICE, PLLC
  • Facility Address: 1024 SW 44TH, STE 800
    OKLAHOMA CITY, OK
    ZIP 73109
  • Facility Phone: 405 816-0053
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CHRISTIANA E. WILLIAMS
  • NPI Number: 1215185491
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 37D1090196
LAB Type Physician Office
Facility Name PROVIDENCE FAMILY PRACTICE, PLLC
Street 1024 SW 44TH, STE 800
City OKLAHOMA CITY
State OK
ZIP 73109
Phone 405 816-0053
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/6/2024
Certificate Expiration Date 10/5/2026
Facility Type Physician Office
Lab Director CHRISTIANA E. WILLIAMS

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