37D2216090 CLIA NUMBER - OPTIMUM PRIMARY CARE, PLLC

Laboratory Demographics

  • CLIA Code: 37D2216090
  • Facility Name: OPTIMUM PRIMARY CARE, PLLC
  • Facility Address: 1501 E 19TH ST
    EDMOND, OK
    ZIP 73013
  • Facility Phone: (405) 471-6511
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: AYESHA MUGHAL
  • NPI Number: 1760030399
  • Taxonomy: 207R00000X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 37D2216090
LAB Type Physician Office
Facility Name OPTIMUM PRIMARY CARE, PLLC
Street 1501 E 19TH ST
City EDMOND
State OK
ZIP 73013
Phone 4054716511
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/9/2025
Certificate Expiration Date 3/8/2027
Facility Type Physician Office
Lab Director AYESHA MUGHAL

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This page was last updated on: 5/18/2026