NPI Details
ST. MARY'S LABORATORY, LLC is a clinical medical laboratory in Enid, OK. The provider is (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. ST. MARY'S LABORATORY, LLC NPI is 1508207242. The provider is registered as an organization entity type.
The provider's business location address is:
3517 W OWEN K GARRIOTT RD
SUITE 5
ENID, OK
ZIP 73703-952
Phone: (580) 234-6800
Fax: (580) 237-1828
The provider's authorized official is John Johannessen .
The authorized official title is Vice President and has the following contact phone number (903) 416-1726.
The CLIA number assigned to this NPI record is 37D2193466 - physician office with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 7/10/2013 and was last updated on 8/28/2014.
Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 291U00000X | Clinical Medical Laboratory | | | | Yes |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | 200505130A | MEDICAID | OKLAHOMA | |
| 2 | 297276 | MEDICARE PIN | OKLAHOMA | |
