37D2284630 CLIA NUMBER - HOMELAND PHARMACY #468

Laboratory Demographics

  • CLIA Code: 37D2284630
  • Facility Name: HOMELAND PHARMACY #468
  • Facility Address: 2005 N 14TH ST, STE 110
    PONCA CITY, OK
    ZIP 74601
  • Facility Phone: 580 462-7444
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DARIN COGGINS
  • NPI Number: 1477592855
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 37D2284630
LAB Type Pharmacy
Facility Name HOMELAND PHARMACY #468
Street 2005 N 14TH ST, STE 110
City PONCA CITY
State OK
ZIP 74601
Phone 580 462-7444
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/27/2025
Certificate Expiration Date 6/26/2027
Facility Type Pharmacy
Lab Director DARIN COGGINS

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