37D2229228 CLIA NUMBER - QUICKCARE FAMILY MEDICINE, LLC

Laboratory Demographics

CLIA Number: 37D2229228

Facility Name: QUICKCARE FAMILY MEDICINE, LLC

Facility Address:
209 W CONNER, STE A
FAIRLAND, OK
ZIP 74343
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Facility Phone Number: 918 964-1076

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1609540731

Taxonomy: 363LF0000X - Nurse Practitioner

CLIA Record

Field Name	Field Value
CLIA Number	37D2229228
LAB Type	Physician Office
Facility Name	QUICKCARE FAMILY MEDICINE, LLC
Street	209 W CONNER, STE A
City	FAIRLAND
State	OK
ZIP	74343
Phone	918 964-1076
CertificateType	4
CertificateEffectiveDate	7/9/2023
CertificateExpirationDate	7/8/2025
FacilityType	Waiver

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