37D2240291 CLIA NUMBER - EVERSIDE HEALTH CENTER-MICHELIN-ARDMORE

Laboratory Demographics

  • CLIA Code: 37D2240291
  • Facility Name: EVERSIDE HEALTH CENTER-MICHELIN-ARDMORE
  • Facility Address: 1105 MICHELIN ROAD
    ARDMORE, OK
    ZIP 73401
  • Facility Phone: 704 936-5546
  • Facility Type: Other - CHRONIC DISEASE MGT
  • Facility Type: Waiver
  • Lab Director: LORI HOBEN
  • NPI Number: 1669149324
  • Taxonomy: 2083P0500X - Preventive Medicine

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CLIA Record

Field Name Field Value
CLIA Number 37D2240291
LAB Type Other - CHRONIC DISEASE MGT
Facility Name EVERSIDE HEALTH CENTER-MICHELIN-ARDMORE
Street 1105 MICHELIN ROAD
City ARDMORE
State OK
ZIP 73401
Phone 704 936-5546
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/19/2023
Certificate Expiration Date 10/18/2025
Facility Type Other - CHRONIC DISEASE MGT
Lab Director LORI HOBEN

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