37D2084547 CLIA NUMBER - AIR-EVAC #122

Laboratory Demographics

  • CLIA Code: 37D2084547
  • Facility Name: AIR-EVAC #122
  • Facility Address: 3705 E MAIN STREET
    WEATHERFORD, OK
    ZIP 73096
  • Facility Phone: 580 772-2803
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: SCOTT MOORE
  • NPI Number: 1265834600
  • Taxonomy: 3416A0800X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 37D2084547
LAB Type Mobile Laboratory
Facility Name AIR-EVAC #122
Street 3705 E MAIN STREET
City WEATHERFORD
State OK
ZIP 73096
Phone 580 772-2803
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/25/2024
Certificate Expiration Date 9/24/2026
Facility Type Mobile Laboratory
Lab Director SCOTT MOORE

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