STATELINE MEDICAL LAB LLC


Address: 105 N Pocola Blvd Ste 2, Pocola, OK 74902-3101
Phone: 9184365001

STATELINE MEDICAL LAB LLC (NPI# 1487275699) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1487275699
Entity Type Organization
Organization Name STATELINE MEDICAL LAB LLC
Practice Address 105 N Pocola Blvd Ste 2
Pocola
OK 74902-3101
Practice Telephone 9184365001
Mailing Telephone 9184365001
Enumeration Date 2020-04-28
Last Update Date 2020-04-28
Authorized Official Name CHRISTOPHER DOOLY (OWNER)
Authorized Official Telephone 4794145680
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 291U00000X Clinical Medical Laboratory Laboratories

Office Location

Street Address 105 N POCOLA BLVD STE 2
City POCOLA
State OK
Zip Code 74902-3101

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1477009611 Ashlyn Beasley Case Manager/Care Coordinator 504 Morris St, Pocola, OK 74902 2016-08-28
1881721637 Pocola Nursing Center LLC Skilled Nursing Facility 200 Home Street, Pocola, OK 74902 2007-02-28
1780776237 Pocola Public Schools Public Health or Welfare 603 E Pryor Ave, Pocola, OK 74902-1901 2006-09-29
1467094524 Tahlina Weir Counselor 205 Cottonwood, Pocola, OK 74902-2340 2019-10-10
1053787283 Amanda Combs Nurse Practitioner 202 Beam Ln, Pocola, OK 74902-2463 2015-08-11
1841458262 John Thomas Coulbourn Counselor 1405 Blair St, Pocola, OK 74902-2860 2008-06-02
1114421260 Stateline Medical LLC Clinical Medical Laboratory 105 N Pocola Blvd, Suite 2, Pocola, OK 74902-3101 2018-03-22
1023362779 Kal Home Health Inc Home Health 302 N Pocola Blvd, Pocola, OK 74902-3102 2012-11-02
1174785091 Shane Thomas Walker Chiropractor 1406 N Pocola Blvd, Pocola, OK 74902-3139 2008-07-01
1225238447 Haisten Enterprises PC Pharmacy 102 E Folsom Blvd, Pocola, OK 74902-3150 2007-07-25
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Taxonomy Information

Taxonomy Code 291U00000X
Grouping Laboratories
Classification Clinical Medical Laboratory

Taxonomy Definition

(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.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1114421260 Stateline Medical LLC Clinical Medical Laboratory 105 N Pocola Blvd, Suite 2, Pocola, OK 74902-3101 2018-03-22

Providers in the same taxonomy and state

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
1790307395 Arc Diagnostics, LLC Clinical Medical Laboratory 8551 N 125th East Ave Ste 150, Owasso, OK 74055-2110 2020-05-18
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
1598284358 Stephanie Sue Mcquarters Clinical Medical Laboratory 1840 South Lion Avenue, Broken Arrow, OK 74012 2017-09-13
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Competitor

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City POCOLA
Zip Code 74902

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Dataset Information

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.

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