37D2138538 CLIA NUMBER - SAINTS DERMATOLOGY - MUSTANG

Laboratory Demographics

  • CLIA Code: 37D2138538
  • Facility Name: SAINTS DERMATOLOGY - MUSTANG
  • Facility Address: 1440 N MUSTANG ROAD
    MUSTANG, OK
    ZIP 73064
  • Facility Phone: 405 280-7546
  • Facility Type: Physician Office
  • Facility Type: Microscopy
  • Lab Director: TIFFANY BRAZEAL
  • NPI Number: 1285138032
  • Taxonomy: 207N00000X - Dermatology

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CLIA Record

Field Name Field Value
CLIA Number 37D2138538
LAB Type Physician Office
Facility Name SAINTS DERMATOLOGY - MUSTANG
Street 1440 N MUSTANG ROAD
City MUSTANG
State OK
ZIP 73064
Phone 405 280-7546
Certificate Type Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.
Certificate Effective Date 10/19/2025
Certificate Expiration Date 10/18/2027
Facility Type Physician Office
Lab Director TIFFANY BRAZEAL

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