37D2188186 CLIA NUMBER - TRIAD COMPLETE HEALTHCARE

Laboratory Demographics

  • CLIA Code: 37D2188186
  • Facility Name: TRIAD COMPLETE HEALTHCARE
  • Facility Address: 2703 N 14TH ST
    PONCA CITY, OK
    ZIP 74601
  • Facility Phone: 580 765-9451
  • Facility Type: Community Clinic
  • Facility Type: Waiver
  • Lab Director: MARK A. OATMAN
  • NPI Number: 1245867258
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 37D2188186
LAB Type Community Clinic
Facility Name TRIAD COMPLETE HEALTHCARE
Street 2703 N 14TH ST
City PONCA CITY
State OK
ZIP 74601
Phone 580 765-9451
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/14/2024
Certificate Expiration Date 7/13/2026
Facility Type Community Clinic
Lab Director MARK A. OATMAN

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