Organization
DIAGNOSTIC LABORATORY OF OKLAHOMA LLC
Active
Other names
GROVE GENERAL HOSPTIAL
Organization subpart
No
Provider details
NPI number
Authorized official
R'NEE MULLEN (CEO)
(405) 608-6290
Entity
Organization
Contact information
Practice address
1001 E 18TH ST, SUITE A, GROVE, OK 74344-2907
(918) 786-2243
Mailing address
14275 MIDWAY RD STE 400, ADDISON, TX 75001-3661
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
37D0700830
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100758750G
—
OK
Enumeration date
12/12/2007
Last updated
10/01/2025
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