37D2196792 CLIA NUMBER - BROOKDALE BROKEN ARROW

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Laboratory Demographics

CLIA Number: 37D2196792

Facility Name: BROOKDALE BROKEN ARROW

Facility Address:
4001 S ASPEN AVE
BROKEN ARROW, OK
ZIP 74011
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Facility Phone Number: 918 451-1987

Facility Type: Assisted Living Facility

Certificate Type: Waiver

NPI Number: 1508032418

Taxonomy: 310400000X - Assisted Living Facility
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

CLIA Record

Field Name	Field Value
CLIA Number	37D2196792
LAB Type	Assisted Living Facility
Facility Name	BROOKDALE BROKEN ARROW
Street	4001 S ASPEN AVE
City	BROKEN ARROW
State	OK
ZIP	74011
Phone	918 451-1987
CertificateType	4
CertificateEffectiveDate	10/20/2022
CertificateExpirationDate	10/19/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024