37D2200148 CLIA NUMBER - IMMEDIATE CARE OF OKLAHOMA - ADMIN

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Laboratory Demographics

CLIA Number: 37D2200148

Facility Name: IMMEDIATE CARE OF OKLAHOMA - ADMIN

Facility Address:
5701 SE 74TH ST, STE E
OKLAHOMA CITY, OK
ZIP 73135
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Facility Phone Number: 405 600-6869

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1578932299

Taxonomy: 261QU0200X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	37D2200148
LAB Type	Physician Office
Facility Name	IMMEDIATE CARE OF OKLAHOMA - ADMIN
Street	5701 SE 74TH ST, STE E
City	OKLAHOMA CITY
State	OK
ZIP	73135
Phone	405 600-6869
CertificateType	4
CertificateEffectiveDate	11/13/2022
CertificateExpirationDate	11/12/2024
FacilityType	Waiver

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