37D2250485 CLIA NUMBER - LAKESIDE PHARMACY

Laboratory Demographics

  • CLIA Code: 37D2250485
  • Facility Name: LAKESIDE PHARMACY
  • Facility Address: 605 N MAIN ST
    EUFAULA, OK
    ZIP 74432
  • Facility Phone: 918 689-9940
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JAMES A. DIXON
  • NPI Number: 1295867612
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 37D2250485
LAB Type Pharmacy
Facility Name LAKESIDE PHARMACY
Street 605 N MAIN ST
City EUFAULA
State OK
ZIP 74432
Phone 918 689-9940
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/27/2024
Certificate Expiration Date 1/26/2026
Facility Type Pharmacy
Lab Director JAMES A. DIXON

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