37D2288691 CLIA NUMBER - OKLAHOMA PEDIATRIC DIGESTIVE INSTITUTE

Laboratory Demographics

  • CLIA Code: 37D2288691
  • Facility Name: OKLAHOMA PEDIATRIC DIGESTIVE INSTITUTE
  • Facility Address: 3300 NW 56, STE 300
    OKLAHOMA CITY, OK
    ZIP 73112
  • Facility Phone: 405 615-4436
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: MARYAM SHAMBAYATI
  • NPI Number: 1407803380
  • Taxonomy: 207RN0300X - Internal Medicine

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CLIA Record

Field Name Field Value
CLIA Number 37D2288691
LAB Type Physician Office
Facility Name OKLAHOMA PEDIATRIC DIGESTIVE INSTITUTE
Street 3300 NW 56, STE 300
City OKLAHOMA CITY
State OK
ZIP 73112
Phone 405 615-4436
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/29/2025
Certificate Expiration Date 8/28/2027
Facility Type Physician Office
Lab Director MARYAM SHAMBAYATI

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