37D2005866 CLIA NUMBER - NORMAN INTERVENTIONAL PAIN MANAGEMENT

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Laboratory Demographics

CLIA Number: 37D2005866

Facility Name: NORMAN INTERVENTIONAL PAIN MANAGEMENT

Facility Address:
3440 RC LUTTRELL DRIVE SUITE 100
NORMAN, OK
ZIP 73072
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Facility Phone Number: 405 701-4909

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1336337393

Taxonomy: 261QP3300X - Clinic/Center

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
CertificateType	4
CertificateEffectiveDate	10/18/2023
CertificateExpirationDate	10/17/2025
FacilityType	Waiver

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