37D2254201 CLIA NUMBER - JULIANNE CLARK PEDIATRICS

Laboratory Demographics

  • CLIA Code: 37D2254201
  • Facility Name: JULIANNE CLARK PEDIATRICS
  • Facility Address: 44038 E 45TH
    SHAWNEE, OK
    ZIP 74804
  • Facility Phone: 405 259-5053
  • Facility Type: Practitioner Other
  • Facility Type: Waiver
  • Lab Director: JULIANNE A. CLARK
  • NPI Number: 1417253170
  • Taxonomy: 363LP0200X - Nurse Practitioner

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CLIA Record

Field Name Field Value
CLIA Number 37D2254201
LAB Type Practitioner Other
Facility Name JULIANNE CLARK PEDIATRICS
Street 44038 E 45TH
City SHAWNEE
State OK
ZIP 74804
Phone 405 259-5053
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 Practitioner Other
Lab Director JULIANNE A. CLARK

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