37D2211500 CLIA NUMBER - MEDWISE, LLC

Laboratory Demographics

  • CLIA Code: 37D2211500
  • Facility Name: MEDWISE, LLC
  • Facility Address: 32 W TAFT AVE, A2
    SAPULPA, OK
    ZIP 74066
  • Facility Phone: 918 727-2840
  • Facility Type: Other - URGENT CARE
  • Facility Type: Waiver
  • Lab Director: DENNIS BLACKSTAD
  • NPI Number: 1538981204
  • Taxonomy: 261QU0200X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 37D2211500
LAB Type Other - URGENT CARE
Facility Name MEDWISE, LLC
Street 32 W TAFT AVE, A2
City SAPULPA
State OK
ZIP 74066
Phone 918 727-2840
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/28/2025
Certificate Expiration Date 1/27/2027
Facility Type Other - URGENT CARE
Lab Director DENNIS BLACKSTAD

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This page was last updated on: 6/4/2025