37D2040679 CLIA NUMBER - LATINO COMMUNITY DEVELOPMENT AGENCY

Laboratory Demographics

  • CLIA Code: 37D2040679
  • Facility Name: LATINO COMMUNITY DEVELOPMENT AGENCY
  • Facility Address: 420 SOUTHWEST 10TH
    OKLAHOMA CITY, OK
    ZIP 73109
  • Facility Phone: (405) 236-0701
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PATRICIA B. FENNELL
  • NPI Number: 1467692038
  • Taxonomy: 251B00000X - Case Management

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CLIA Record

Field Name Field Value
CLIA Number 37D2040679
LAB Type Physician Office
Facility Name LATINO COMMUNITY DEVELOPMENT AGENCY
Street 420 SOUTHWEST 10TH
City OKLAHOMA CITY
State OK
ZIP 73109
Phone 4052360701
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/8/2026
Certificate Expiration Date 5/7/2028
Facility Type Physician Office
Lab Director PATRICIA B. FENNELL

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