37D2000059 CLIA NUMBER - OKLAHOMA STATE UNIVERSITY TELEMEDICINE

Laboratory Demographics

  • CLIA Code: 37D2000059
  • Facility Name: OKLAHOMA STATE UNIVERSITY TELEMEDICINE
  • Facility Address: 1111 W 17TH ST
    TULSA, OK
    ZIP 74107
  • Facility Phone: (918) 584-4609
  • Facility Type: Other - MOBILE RURAL HEALTH CLNC
  • Facility Type: Waiver
  • Lab Director: STEPHEN CASADY
  • NPI Number: 1306882261
  • Taxonomy: 261QM2500X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 37D2000059
LAB Type Other - MOBILE RURAL HEALTH CLNC
Facility Name OKLAHOMA STATE UNIVERSITY TELEMEDICINE
Street 1111 W 17TH ST
City TULSA
State OK
ZIP 74107
Phone 9185844609
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/19/2025
Certificate Expiration Date 11/18/2027
Facility Type Other - MOBILE RURAL HEALTH CLNC
Lab Director STEPHEN CASADY

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This page was last updated on: 5/18/2026