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Organization

BOARD OF REGENTS OF THE UNIVERSITY OF OKLAHOMA

Active
Other names
OU Oral Pathology Laboratory
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RONALD FARAM DDS (ORAL PATHOLOGY DIVISION HEAD)
(405) 271-4333
Entity
Organization

Contact information

Practice address
1201 N STONEWALL AVE RM 280, OKLAHOMA CITY, OK 73117-1214
(405) 271-4333
(405) 271-3385
Mailing address
PO BOX 268804, OKLAHOMA CITY, OK 73126-8804
(405) 271-4333
(405) 271-3385

Taxonomy

Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200006220A
OK
01
37D0856444
CLIA CERTIFICATE
OK
Enumeration date
09/20/2006
Last updated
08/19/2024
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