37D2145346 CLIA NUMBER - CLASSEN FAMILY MEDICINE

Laboratory Demographics

  • CLIA Code: 37D2145346
  • Facility Name: CLASSEN FAMILY MEDICINE
  • Facility Address: 1015 SW 4TH ST
    MOORE, OK
    ZIP 73160
  • Facility Phone: 405 378-2001
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: DOUGLAS RIDDLE
  • NPI Number: 1063927408
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 37D2145346
LAB Type Physician Office
Facility Name CLASSEN FAMILY MEDICINE
Street 1015 SW 4TH ST
City MOORE
State OK
ZIP 73160
Phone 405 378-2001
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/6/2024
Certificate Expiration Date 3/5/2026
Facility Type Physician Office
Lab Director DOUGLAS RIDDLE

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