37D2089523 CLIA NUMBER - UTICA PARK CLINIC-DERMATOLOGY

Laboratory Demographics

  • CLIA Code: 37D2089523
  • Facility Name: UTICA PARK CLINIC-DERMATOLOGY
  • Facility Address: 9245 S MINGO RD
    TULSA, OK
    ZIP 74133
  • Facility Phone: 918 492-8980
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: BRITTNEY J. BONNER
  • NPI Number: 1467836692
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 37D2089523
LAB Type Community Clinic
Facility Name UTICA PARK CLINIC-DERMATOLOGY
Street 9245 S MINGO RD
City TULSA
State OK
ZIP 74133
Phone 918 492-8980
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/1/2025
Certificate Expiration Date 3/31/2027
Facility Type Community Clinic
Lab Director BRITTNEY J. BONNER

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