37D2012064 CLIA NUMBER - WALGREENS #07698

Laboratory Demographics

  • CLIA Code: 37D2012064
  • Facility Name: WALGREENS #07698
  • Facility Address: 2300 N 14TH STREET
    PONCA CITY, OK
    ZIP 74601
  • Facility Phone: 580 767-1584
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KAYDEE M. JUDD
  • NPI Number: 1255346235
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 37D2012064
LAB Type Pharmacy
Facility Name WALGREENS #07698
Street 2300 N 14TH STREET
City PONCA CITY
State OK
ZIP 74601
Phone 580 767-1584
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/2/2025
Certificate Expiration Date 4/1/2027
Facility Type Pharmacy
Lab Director KAYDEE M. JUDD

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