Organization
DIAGNOSTIC LABORATORY OF OKLAHOMA, LLC
Active
Parent organization
DIAGNOSTIC LABORATORY OF OKLAHOMA
Other names
Lakeside Women's Hospital
Organization subpart
Yes
Provider details
NPI number
Legal business name
DIAGNOSTIC LABORATORY OF OKLAHOMA
Authorized official
R'NEE MULLEN (CEO)
(405) 608-6290
Entity
Organization
Contact information
Practice address
11200 N PORTLAND AVE, OKLAHOMA CITY, OK 73120-5045
(405) 936-1566
Mailing address
14275 MIDWAY RD STE 400, ADDISON, TX 75001-3661
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100758750
—
OK
Enumeration date
09/15/2011
Last updated
10/01/2025
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