37D2207085 CLIA NUMBER - MEDWISE, LLC

Laboratory Demographics

  • CLIA Code: 37D2207085
  • Facility Name: MEDWISE, LLC
  • Facility Address: 1095 N ASPEN AVE
    BROKEN ARROW, OK
    ZIP 74012
  • Facility Phone: 918 727-2870
  • Facility Type: Other - URGENT CARE
  • Facility Type: Waiver
  • Lab Director: DENNIS BLACKSTAD
  • NPI Number: 1730993460
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 37D2207085
LAB Type Other - URGENT CARE
Facility Name MEDWISE, LLC
Street 1095 N ASPEN AVE
City BROKEN ARROW
State OK
ZIP 74012
Phone 918 727-2870
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/23/2024
Certificate Expiration Date 12/22/2026
Facility Type Other - URGENT CARE
Lab Director DENNIS BLACKSTAD

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