37D2305616 CLIA NUMBER - BRADLEY BIBB MD PLLC

Laboratory Demographics

  • CLIA Code: 37D2305616
  • Facility Name: BRADLEY BIBB MD PLLC
  • Facility Address: 1201 E HARTFORD AVE
    PONCA CITY, OK
    ZIP 74601
  • Facility Phone: 580 762-1911
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: CHADWICK ROSS
  • NPI Number: 1568200061
  • Taxonomy: 261QR1300X - Clinic/Center

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CLIA Record

Field Name Field Value
CLIA Number 37D2305616
LAB Type Physician Office
Facility Name BRADLEY BIBB MD PLLC
Street 1201 E HARTFORD AVE
City PONCA CITY
State OK
ZIP 74601
Phone 580 762-1911
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/1/2025
Certificate Expiration Date 12/31/2026
Facility Type Physician Office
Lab Director CHADWICK ROSS

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