37D2005866 CLIA NUMBER - NORMAN INTERVENTIONAL PAIN MANAGEMENT

Laboratory Demographics

  • CLIA Code: 37D2005866
  • Facility Name: NORMAN INTERVENTIONAL PAIN MANAGEMENT
  • Facility Address: 3440 RC LUTTRELL DRIVE SUITE 100
    NORMAN, OK
    ZIP 73072
  • Facility Phone: 405 701-4909
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: SHANE STIDHAM
  • NPI Number: 1336337393
  • Taxonomy: 261QP3300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 37D2005866
LAB Type Physician Office
Facility Name NORMAN INTERVENTIONAL PAIN MANAGEMENT
Street 3440 RC LUTTRELL DRIVE SUITE 100
City NORMAN
State OK
ZIP 73072
Phone 405 701-4909
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/18/2023
Certificate Expiration Date 10/17/2025
Facility Type Physician Office
Lab Director SHANE STIDHAM

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