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37D2090405 CLIA NUMBER - INTEGRIS HEALTH MEDICAL GROUP OKLAHOMA AVENUE

Laboratory Demographics

CLIA Number: 37D2090405

Facility Name: INTEGRIS HEALTH MEDICAL GROUP OKLAHOMA AVENUE

Facility Address:
1021 OKLAHOMA AVE
WOODWARD, OK
ZIP 73801
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Facility Phone Number: 580 290-6424

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1073782462

Taxonomy: 213E00000X - Podiatrist
A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy.

CLIA Record

Field Name Field Value
CLIA Number 37D2090405
LAB Type Physician Office
Facility Name INTEGRIS HEALTH MEDICAL GROUP OKLAHOMA AVENUE
Street 1021 OKLAHOMA AVE
City WOODWARD
State OK
ZIP 73801
Phone 580 290-6424
CertificateType 4
CertificateEffectiveDate 1/22/2023
CertificateExpirationDate 1/21/2025
FacilityType Waiver

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