37D2124776 CLIA NUMBER - GREAT PLAINS VISION CENTER

Laboratory Demographics

  • CLIA Code: 37D2124776
  • Facility Name: GREAT PLAINS VISION CENTER
  • Facility Address: 1418 MAIN ST
    WOODWARD, OK
    ZIP 73801
  • Facility Phone: 580 256-6699
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: JACOBY J. DEWALD
  • NPI Number: 1194017020
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 37D2124776
LAB Type Physician Office
Facility Name GREAT PLAINS VISION CENTER
Street 1418 MAIN ST
City WOODWARD
State OK
ZIP 73801
Phone 580 256-6699
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/25/2025
Certificate Expiration Date 1/24/2027
Facility Type Physician Office
Lab Director JACOBY J. DEWALD

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