37D2074695 CLIA NUMBER - GRANITE FAMILY MEDICAL CLINIC

Laboratory Demographics

  • CLIA Code: 37D2074695
  • Facility Name: GRANITE FAMILY MEDICAL CLINIC
  • Facility Address: 417 N MAIN STREET
    GRANITE, OK
    ZIP 73547
  • Facility Phone: 580 535-4598
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: NICOLE EVANS
  • NPI Number: 1396911830
  • Taxonomy: 261QP2300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 37D2074695
LAB Type Physician Office
Facility Name GRANITE FAMILY MEDICAL CLINIC
Street 417 N MAIN STREET
City GRANITE
State OK
ZIP 73547
Phone 580 535-4598
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/13/2024
Certificate Expiration Date 3/12/2026
Facility Type Physician Office
Lab Director NICOLE EVANS

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