37D2266061 CLIA NUMBER - STELLAR PEDIATRIC URGENT CARE

Laboratory Demographics

  • CLIA Code: 37D2266061
  • Facility Name: STELLAR PEDIATRIC URGENT CARE
  • Facility Address: 1201 MAGNOLIA CT
    MOORE, OK
    ZIP 73160
  • Facility Phone: 405 857-7681
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: BRIAN T. ELLIS
  • NPI Number: 1528793478
  • Taxonomy: 208000000X - Pediatrics

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CLIA Record

Field Name Field Value
CLIA Number 37D2266061
LAB Type Physician Office
Facility Name STELLAR PEDIATRIC URGENT CARE
Street 1201 MAGNOLIA CT
City MOORE
State OK
ZIP 73160
Phone 405 857-7681
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/4/2024
Certificate Expiration Date 8/3/2026
Facility Type Physician Office
Lab Director BRIAN T. ELLIS

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