Organization
OKLAHOMA STATE DEPARTMENT OF HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER HAN PH.D. (DIRECTOR)
(405) 426-8139
Entity
Organization
Contact information
Practice address
4615 W LAKEVIEW RD, STILLWATER, OK 74075-2173
(405) 564-7750
Mailing address
123 ROBERT S KERR AVE STE 1702, OKLAHOMA CITY, OK 73102-6406
(405) 426-8650
(405) 900-7598
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100758760A
—
OK
Enumeration date
03/23/2007
Last updated
12/05/2025
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