37D2146795 CLIA NUMBER - EXPRESS RX OF COWETA NW COWETA, LLC

Laboratory Demographics

  • CLIA Code: 37D2146795
  • Facility Name: EXPRESS RX OF COWETA NW COWETA, LLC
  • Facility Address: 12071 S STATE HIGHWAY 51
    COWETA, OK
    ZIP 74429
  • Facility Phone: 918 887-1040
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ERIC CRUMBAUGH
  • NPI Number: 1588112064
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 37D2146795
LAB Type Pharmacy
Facility Name EXPRESS RX OF COWETA NW COWETA, LLC
Street 12071 S STATE HIGHWAY 51
City COWETA
State OK
ZIP 74429
Phone 918 887-1040
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/18/2024
Certificate Expiration Date 6/17/2026
Facility Type Pharmacy
Lab Director ERIC CRUMBAUGH

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