37D2054469 CLIA NUMBER - JACK E MARSHALL, MD, LLC

Laboratory Demographics

  • CLIA Code: 37D2054469
  • Facility Name: JACK E MARSHALL, MD, LLC
  • Facility Address: 14100 PARKWAY COMMONS DR, STE 100
    OKLAHOMA CITY, OK
    ZIP 73134
  • Facility Phone: 405 286-9820
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JACK E. MARSHALL
  • NPI Number: 1982608873
  • Taxonomy: 208VP0014X - Pain Medicine

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CLIA Record

Field Name Field Value
CLIA Number 37D2054469
LAB Type Physician Office
Facility Name JACK E MARSHALL, MD, LLC
Street 14100 PARKWAY COMMONS DR, STE 100
City OKLAHOMA CITY
State OK
ZIP 73134
Phone 405 286-9820
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/21/2025
Certificate Expiration Date 2/20/2027
Facility Type Physician Office
Lab Director JACK E. MARSHALL

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