37D2073978 CLIA NUMBER - OUP HEALTH & WELLNESS CLINIC

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Laboratory Demographics

CLIA Number: 37D2073978

Facility Name: OUP HEALTH & WELLNESS CLINIC

Facility Address:
825 NE 10TH ST, 4A
OKLAHOMA CITY, OK
ZIP 73104
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Facility Phone Number: 405 271-9675

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1922193374

Taxonomy: 261Q00000X - Clinic/Center
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).

CLIA Record

Field Name	Field Value
CLIA Number	37D2073978
LAB Type	Physician Office
Facility Name	OUP HEALTH & WELLNESS CLINIC
Street	825 NE 10TH ST, 4A
City	OKLAHOMA CITY
State	OK
ZIP	73104
Phone	405 271-9675
CertificateType	4
CertificateEffectiveDate	2/27/2024
CertificateExpirationDate	2/26/2026
FacilityType	Waiver

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This page was last updated on: 4/23/2024