37D2102418 CLIA NUMBER - AIR EVAC LIFETEAM AEL #128 AIR EVAC EMS INC

Laboratory Demographics

  • CLIA Code: 37D2102418
  • Facility Name: AIR EVAC LIFETEAM AEL #128 AIR EVAC EMS INC
  • Facility Address: 311 FAIRVIEW AVE
    PONCA CITY, OK
    ZIP 74601
  • Facility Phone: (580) 761-7706
  • Facility Type: Mobile Laboratory
  • Facility Type: Waiver
  • Lab Director: JOHN MITCHELL
  • NPI Number: 1790154391
  • Taxonomy: 3416A0800X - Ambulance

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CLIA Record

Field Name Field Value
CLIA Number 37D2102418
LAB Type Mobile Laboratory
Facility Name AIR EVAC LIFETEAM AEL #128 AIR EVAC EMS INC
Street 311 FAIRVIEW AVE
City PONCA CITY
State OK
ZIP 74601
Phone 5807617706
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 Mobile Laboratory
Lab Director JOHN MITCHELL

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This page was last updated on: 5/18/2026