DIAGNOSTIC LABORATORY OF OKLAHOMA LLC (NPI# 1255517348) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255517348 |
| Entity Type | Organization |
| Organization Name | DIAGNOSTIC LABORATORY OF OKLAHOMA LLC |
| Other Organization Name | OWASSO OKLAHOMA |
| Practice Address |
10502 N 110th East Ave Owasso OK 74055-6655 |
| Mailing Address |
1201 S Collegeville Rd Collegeville PA 19426-2998 |
| Practice Telephone | 9183768150 |
| Mailing Telephone | 8666978378 |
| Enumeration Date | 2008-01-18 |
| Last Update Date | 2018-12-11 |
| Authorized Official Name | LEO SELL (CONTROLLER) |
| Authorized Official Telephone | 4056086298 |
| Is Organization Subpart | Y |
| Parent Organization Name | DIAGNOSTIC LABORATORY OF OKLAHOMA |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 291U00000X | Clinical Medical Laboratory | 37D1059452 | OK | Laboratories |
| Other Name | Type Code |
|---|---|
| Owasso Oklahoma | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356443741 | Diagnostic Laboratory of Oklahoma LLC | Clinical Medical Laboratory | 225 Ne 97th St Suite 1000, Cytology Department, Oklahoma City, OK 73114-7408 | 2006-09-05 |
| 1770529513 | Diagnostic Laboratory of Oklahoma LLC | Clinical Medical Laboratory | 225 Ne 97th Street, Oklahoma City, OK 73114 | 2006-06-21 |
| 1285057455 | Diagnostic Laboratory of Oklahoma LLC | Clinical Medical Laboratory | 3300 Nw Expressway, Hla Laboratory 2nd Floor #2259, Oklahoma City, OK 73112-4462 | 2014-01-24 |
| 1346428893 | Diagnostic Laboratory of Oklahoma LLC | Clinical Medical Laboratory | 4401 S Western Ave, Oklahoma City, OK 73109-3413 | 2008-02-07 |
| 1750569661 | Diagnostic Laboratory of Oklahoma LLC | Clinical Medical Laboratory | 1201 Health Center Pkwy, Laboratory, Yukon, OK 73099-6381 | 2008-02-01 |
| 1093993917 | Diagnostic Laboratory of Oklahoma LLC | Clinical Medical Laboratory | 1 Hospital Drive, Madill, OK 73446-0827 | 2008-02-01 |
| 1376721290 | Diagnostic Laboratory of Oklahoma LLC | Clinical Medical Laboratory | 710 S 13th St, Blackwell, OK 74631-3700 | 2008-02-01 |
| 1134307044 | Diagnostic Laboratory of Oklahoma LLC | Clinical Medical Laboratory | 111 N Bailey St, Pryor, OK 74361-4201 | 2008-02-01 |
| 1194903013 | Diagnostic Laboratory of Oklahoma LLC | Clinical Medical Laboratory | 600 S Monroe St, Enid, OK 73701-7211 | 2008-02-01 |
| 1003094913 | Diagnostic Laboratory of Oklahoma LLC | Clinical Medical Laboratory | 100 N 30th St, Suite Laboratory, Clinton, OK 73601-3117 | 2008-02-01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | DIAGNOSTIC LABORATORY OF OKLAHOMA LLC | 225 Ne 97th St, Oklahoma City, OK 73114-6302 |
| Street Address |
10502 N 110TH EAST AVE |
| City | OWASSO |
| State | OK |
| Zip Code | 74055-6655 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588652929 | Gregory Paul Disalvatore | Family Medicine | 10502 N 110th East Ave, Owasso, OK 74055-6655 | 2005-10-10 |
| 1316597131 | Emilee Legg | Physical Therapy Assistant | 10502 N 110th East Ave, Owasso, OK 74055-6655 | 2019-09-13 |
| 1811352776 | Bird Creek Emergency Physicians LLC | Emergency Medicine | 10502 N 110th East Ave, Owasso, OK 74055-6655 | 2015-12-20 |
| 1053623884 | Wesley Updike | Family Medicine | 10502 N 110th East Ave, Owasso, OK 74055-6655 | 2010-07-09 |
| 1467692475 | Jeremy Bymaster | Pharmacist | 10502 N 110th East Ave, Owasso, OK 74055-6655 | 2009-03-03 |
| 1790984938 | Mark P Britt, Md Pllc | Internal Medicine | 10502 N 110th East Ave, Ste 334, Owasso, OK 74055-6655 | 2007-07-17 |
| 1932287281 | Ronald Steve Stevens | Anesthesiology | 10502 N 110th East Ave, Owasso, OK 74055-6627 | 2006-11-02 |
| 1720165830 | Green Country Emergency Physicians Group of Owasso Pllc | Emergency Medicine | 10502 N 110th East Ave, Owasso, OK 74055-6655 | 2006-11-01 |
| 1205846037 | Bailey Medical Center, LLC | General Acute Care Hospital | 10502 N 110th East Ave, Owasso, OK 74055-6655 | 2006-08-08 |
| 1619996030 | Pamala Lea Wilson | Nurse Anesthetist, Certified Registered | 10502 N 110th East Ave, Owasso, OK 74055-6627 | 2006-07-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972151587 | Lakecrest Dental-owasso 96th | Dentist | 9551 N. Owasso Expressway, Suite #100, Owasso, OK 74055 | 2019-08-27 |
| 1205328697 | Eddie Duane Gaut | Case Manager/Care Coordinator | 110 W 3rd St., Apt 11, Owasso, OK 74055 | 2018-06-01 |
| 1821586694 | Kaitlyn Konarik | Speech-Language Pathologist | 12899 E 76th St N, Ste. 109, Owasso, OH 74055 | 2018-04-27 |
| 1043733769 | Kelsey Renae Nicklas | Case Manager/Care Coordinator | 9310 N 163rd East Ave, Owasso, OK 74055 | 2017-07-25 |
| 1700259256 | Genscripts Owasso, LLC | Pharmacy | 9538 N Garnett Rd, Suite 102, Owasso, OK 74055 | 2015-11-05 |
| 1770968810 | Premier Anesthesia Management Inc | Clinic/Center | 19236 E Twin Creeks Dr, Owasso, OK 74055 | 2015-07-29 |
| 1598152407 | Justin Lum | Physical Therapist | 12326 E 86th St N, Owasso, OK 74055 | 2015-04-17 |
| 1033507660 | Kimberly Louise Howard | Physical Therapy Assistant | 12899 East 76th St North, Owasso, OK 74055 | 2015-01-06 |
| 1780920629 | Timothy Ryan Thornton | Behavioral Analyst | 11330 N 94 E Ave, Owasso, OK 74055 | 2012-12-21 |
| 1679842785 | Kelli Marie Ellis | Counselor | 19760 E Fox Run Cir, Owasso, OK 74055 | 2011-12-19 |
| Find all providers in zip 74055 | ||||
| Taxonomy Code | 291U00000X |
| Grouping | Laboratories |
| Classification | Clinical Medical Laboratory |
| (1) A clinical laboratory is a facility for the biological, microbiological, serological, chemical, immunohematological, hematological, biophysical, cytological, pathological, or other examination of materials derived from the human body for the purpose of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, human beings. These examinations also include procedures to determine, measure, or otherwise describe the presence or absence of various substances or organisms in the body. Facilities only collecting or preparing specimens (or both) or only serving as a mailing service and not performing testing are not considered clinical laboratories. (2) Any facility that examines materials from the human body for purposes of providing information for the diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of, the health of human beings. Typical divisions of a clinical laboratory include hematology, cytology, bacteriology, histology, biochemistry, medical toxicology, and serology. |
| Notes: Source: (1) Code of Federal Regulations #42, Public Health, Section 493.2. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 186. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790307395 | Arc Diagnostics, LLC | Clinical Medical Laboratory | 8551 N 125th East Ave Ste 150, Owasso, OK 74055-2110 | 2020-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427657360 | Chrom Medical Labs | Clinical Medical Laboratory | 12816 S Memorial Dr Unit 121, Bixby, OK 74008-2593 | 2020-10-21 |
| 1043835143 | Qitek Labs of Oklahoma, LLC | Clinical Medical Laboratory | 3636 Nw 63rd St Ste C, Oklahoma City, OK 73116-2011 | 2020-06-15 |
| 1487275699 | Stateline Medical Lab LLC | Clinical Medical Laboratory | 105 N Pocola Blvd Ste 2, Pocola, OK 74902-3101 | 2020-04-28 |
| 1417583162 | Imaginus Diagnostic Laboratory LLC | Clinical Medical Laboratory | 17673 Us Highway 271, Spiro, OK 74959-5300 | 2020-03-13 |
| 1366089633 | Wellness Labs, LLC | Clinical Medical Laboratory | 5272 S Lewis Ave Ste 120, Tulsa, OK 74105-6563 | 2019-12-05 |
| 1669021622 | National Laboratory Corporation | Clinical Medical Laboratory | 5805 E 15th St Ste 104, Tulsa, OK 74112-6401 | 2019-09-11 |
| 1720636806 | Axiom Biogenomics, LLC | Clinical Medical Laboratory | 7335 S Lewis Ave Ste 120, Tulsa, OK 74136-6830 | 2019-08-31 |
| 1881178010 | Progentec Diagnostics Inc. | Clinical Medical Laboratory | 825 Ne 13th St Ste Mc302.4, Oklahoma City, OK 73104-5005 | 2018-09-24 |
| 1891280541 | Wellness Federal Labs, LLC | Clinical Medical Laboratory | 5272 S Lewis Ave Ste 121, Tulsa, OK 74105-6563 | 2018-06-26 |
| 1114421260 | Stateline Medical LLC | Clinical Medical Laboratory | 105 N Pocola Blvd, Suite 2, Pocola, OK 74902-3101 | 2018-03-22 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.