37D2096023 CLIA NUMBER - JOINT RECONSTRUCTIVE SPECIALIST

Laboratory Demographics

  • CLIA Code: 37D2096023
  • Facility Name: JOINT RECONSTRUCTIVE SPECIALIST
  • Facility Address: 3110 SW 89TH STREET, STE 200D
    OKLAHOMA CITY, OK
    ZIP 73159
  • Facility Phone: 000 405-6805
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: PAUL D. MAITINO
  • NPI Number: 1629187596
  • Taxonomy: 207X00000X - Orthopaedic Surgery

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CLIA Record

Field Name Field Value
CLIA Number 37D2096023
LAB Type Physician Office
Facility Name JOINT RECONSTRUCTIVE SPECIALIST
Street 3110 SW 89TH STREET, STE 200D
City OKLAHOMA CITY
State OK
ZIP 73159
Phone 000 405-6805
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/14/2025
Certificate Expiration Date 5/13/2027
Facility Type Physician Office
Lab Director PAUL D. MAITINO

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