37D2102404 CLIA NUMBER - IDABEL DIALYSIS

Laboratory Demographics

  • CLIA Code: 37D2102404
  • Facility Name: IDABEL DIALYSIS
  • Facility Address: 1319 S LYNN LANE
    IDABEL, OK
    ZIP 74745
  • Facility Phone: 580 286-1108
  • Facility Type: End Stage Renal Disease Dialysis Facility
  • Facility Type: Waiver
  • Lab Director: ROBERT LEACH
  • NPI Number: 1043694383
  • Taxonomy: 261QE0700X - Clinic/Center

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 37D2102404
LAB Type End Stage Renal Disease Dialysis Facility
Facility Name IDABEL DIALYSIS
Street 1319 S LYNN LANE
City IDABEL
State OK
ZIP 74745
Phone 580 286-1108
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/22/2025
Certificate Expiration Date 9/21/2027
Facility Type End Stage Renal Disease Dialysis Facility
Lab Director ROBERT LEACH

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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