37D2164077 CLIA NUMBER - TELLANEURODOC, LLC

Laboratory Demographics

  • CLIA Code: 37D2164077
  • Facility Name: TELLANEURODOC, LLC
  • Facility Address: 3432 NW 178TH ST, SUITE A
    EDMOND, OK
    ZIP 73012
  • Facility Phone: 405 696-3773
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KENT R. SMALLEY
  • NPI Number: 1164986774
  • Taxonomy: 204D00000X - Neuromusculoskeletal Medicine & OMM

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CLIA Record

Field Name Field Value
CLIA Number 37D2164077
LAB Type Physician Office
Facility Name TELLANEURODOC, LLC
Street 3432 NW 178TH ST, SUITE A
City EDMOND
State OK
ZIP 73012
Phone 405 696-3773
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/27/2025
Certificate Expiration Date 3/26/2027
Facility Type Physician Office
Lab Director KENT R. SMALLEY

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