37D2047518 CLIA NUMBER - HEALTHCARE STAT

Laboratory Demographics

  • CLIA Code: 37D2047518
  • Facility Name: HEALTHCARE STAT
  • Facility Address: 1619 S 4TH ST
    CHICKASHA, OK
    ZIP 73018
  • Facility Phone: 405 485-9588
  • Facility Type: Practitioner Other
  • Facility Type: Microscopy
  • Lab Director: SHAWN BONILLA
  • NPI Number: 1609029644
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 37D2047518
LAB Type Practitioner Other
Facility Name HEALTHCARE STAT
Street 1619 S 4TH ST
City CHICKASHA
State OK
ZIP 73018
Phone 405 485-9588
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 9/25/2024
Certificate Expiration Date 9/24/2026
Facility Type Practitioner Other
Lab Director SHAWN BONILLA

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