37D2071782 CLIA NUMBER - FMC IDABEL DIALYSIS

Laboratory Demographics

  • CLIA Code: 37D2071782
  • Facility Name: FMC IDABEL DIALYSIS
  • Facility Address: 1104 EAST LINCON
    IDABEL, OK
    ZIP 74745
  • Facility Phone: 580 286-5030
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: MARK W. GREENWELL
  • NPI Number: 1134549660
  • Taxonomy: 261QE0700X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 37D2071782
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name FMC IDABEL DIALYSIS
Street 1104 EAST LINCON
City IDABEL
State OK
ZIP 74745
Phone 580 286-5030
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/17/2024
Certificate Expiration Date 1/16/2026
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director MARK W. GREENWELL

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This page was last updated on: 6/4/2025