37D2004751 CLIA NUMBER - GENERATIONS FAMILY MEDICAL

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Laboratory Demographics

CLIA Number: 37D2004751

Facility Name: GENERATIONS FAMILY MEDICAL

Facility Address:
206 E BLUE STARR DRIVE
CLAREMORE, OK
ZIP 74017
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Facility Phone Number: 918 341-8100

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1720148851

Taxonomy: 261QH0100X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	37D2004751
LAB Type	Physician Office
Facility Name	GENERATIONS FAMILY MEDICAL
Street	206 E BLUE STARR DRIVE
City	CLAREMORE
State	OK
ZIP	74017
Phone	918 341-8100
CertificateType	4
CertificateEffectiveDate	3/11/2024
CertificateExpirationDate	3/10/2026
FacilityType	Waiver

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