37D2264030 CLIA NUMBER - WILMA P MANKILLER DENTAL CLINIC-CHEROKEE NATION

Laboratory Demographics

CLIA Code: 37D2264030
Facility Name: WILMA P MANKILLER DENTAL CLINIC-CHEROKEE NATION
Facility Address: 471688 HIGHWAY 51
STILWELL, OK
ZIP 74960
Facility Phone: 918 410-2752
Facility Type: Federally Qualified Health Center
Facility Type: Waiver
Lab Director: MATTHEW G. REECE
NPI Number: 1497791859
Taxonomy: 332800000X - Indian Health Service/Tribal/Urban Indian Health (I/T/U) Pharmacy

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CLIA Record

Field Name	Field Value
CLIA Number	37D2264030
LAB Type	Federally Qualified Health Center
Facility Name	WILMA P MANKILLER DENTAL CLINIC-CHEROKEE NATION
Street	471688 HIGHWAY 51
City	STILWELL
State	OK
ZIP	74960
Phone	918 410-2752
Certificate Type	Certificate of Waiver
Certificate Type Description	This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date	7/8/2024
Certificate Expiration Date	7/7/2026
Facility Type	Federally Qualified Health Center
Lab Director	MATTHEW G. REECE

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