37D2254177 CLIA NUMBER - ENTRUST DPC, PLLC

Laboratory Demographics

  • CLIA Code: 37D2254177
  • Facility Name: ENTRUST DPC, PLLC
  • Facility Address: 1425 N MAIN ST, STE 1
    FAIRVIEW, OK
    ZIP 73737
  • Facility Phone: 580 227-8647
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: ANDREA E. MCEACHERN
  • NPI Number: 1841941887
  • Taxonomy: 207Q00000X - Family Medicine

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CLIA Record

Field Name Field Value
CLIA Number 37D2254177
LAB Type Physician Office
Facility Name ENTRUST DPC, PLLC
Street 1425 N MAIN ST, STE 1
City FAIRVIEW
State OK
ZIP 73737
Phone 580 227-8647
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/1/2024
Certificate Expiration Date 2/28/2026
Facility Type Physician Office
Lab Director ANDREA E. MCEACHERN

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