37D2160142 CLIA NUMBER - LIFE PACE, INC

Laboratory Demographics

CLIA Code: 37D2160142
Facility Name: LIFE PACE, INC
Facility Address: 3106 S JUNIPER AVE
BROKEN ARROW, OK
ZIP 74012
Facility Phone: (918) 664-9000
Facility Type: Other - ADULT DAY HEALTH
Facility Type: Waiver
Lab Director: SAMANTHA R. BLUE
NPI Number: 1023407376
Taxonomy: 251T00000X - Program of All-Inclusive Care for the Elderly (PACE) Provider Organization

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CLIA Record

Field Name	Field Value
CLIA Number	37D2160142
LAB Type	Other - ADULT DAY HEALTH
Facility Name	LIFE PACE, INC
Street	3106 S JUNIPER AVE
City	BROKEN ARROW
State	OK
ZIP	74012
Phone	9186649000
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	1/4/2025
Certificate Expiration Date	1/3/2027
Facility Type	Other - ADULT DAY HEALTH
Lab Director	SAMANTHA R. BLUE

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