37D2067845 CLIA NUMBER - FIVE OAKS FAMILY MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 37D2067845
  • Facility Name: FIVE OAKS FAMILY MEDICAL CLINIC
  • Facility Address: 2100 WEST IOWA AVENUE, SUITE A
    CHICKASHA, OK
    ZIP 73018
  • Facility Phone: 405 779-2720
  • Facility Type: Rural Health Clinic
  • Facility Type: Waiver
  • Lab Director: MITCHELL D. COPPEDGE
  • NPI Number: 1164859260
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 37D2067845
LAB Type Rural Health Clinic
Facility Name FIVE OAKS FAMILY MEDICAL CLINIC
Street 2100 WEST IOWA AVENUE, SUITE A
City CHICKASHA
State OK
ZIP 73018
Phone 405 779-2720
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/23/2023
Certificate Expiration Date 10/22/2025
Facility Type Rural Health Clinic
Lab Director MITCHELL D. COPPEDGE

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