37D2179425 CLIA NUMBER - PETERSON HEALTHCARE, LLC

Laboratory Demographics

  • CLIA Code: 37D2179425
  • Facility Name: PETERSON HEALTHCARE, LLC
  • Facility Address: 217 N HARRISON AVE, STE 109
    BLANCHARD, OK
    ZIP 73010
  • Facility Phone: 405 888-8483
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: STEVEN BANDER
  • NPI Number: 1033762513
  • Taxonomy: 363LF0000X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 37D2179425
LAB Type Physician Office
Facility Name PETERSON HEALTHCARE, LLC
Street 217 N HARRISON AVE, STE 109
City BLANCHARD
State OK
ZIP 73010
Phone 405 888-8483
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/24/2024
Certificate Expiration Date 2/23/2026
Facility Type Physician Office
Lab Director STEVEN BANDER

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