NPIMap

Organization Active NPI

Diagnostic Laboratory of Oklahoma LLC

  • Clinical Medical Laboratory
  • Oklahoma City, OK
National Provider Identifier
1285057455
Registry record updated Oct 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
37D2068295 Issued in OK
Legal business name
DIAGNOSTIC LABORATORY OF OKLAHOMA LLC
Practice address
3300 NW Expressway
Hla Laboratory 2ND Floor #2259
Oklahoma City, OK 73112-4462
Phone
(405) 713-7002
NPI assigned
Jan 24, 2014
Last updated
Oct 1, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
R'Nee Mullen
Title
Ceo
Phone
(405) 608-6290

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 37D2068295 OK Primary

Addresses

Primary practice location

3300 NW Expressway
Hla Laboratory 2ND Floor #2259
Oklahoma City, OK 73112-4462

Mailing address

14275 Midway Rd Ste 400
Addison, TX 75001-3661

Other identifiers 1

IdentifierTypeStateIssuer
100758750AMedicaidOK

Other names 1

  • Transplant Immunology Laboratory Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040811000543 OK Part B Supplier - Independent Clinical Laboratory 9032181953 20 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Miami, OK; Yukon, OK; Tulsa, OK; Owasso, OK; Oklahoma City, OK; Grove, OK; Enid, OK; Edmond, OK

Other NPIs on the same Medicare enrollment 20

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 20

National Provider Directory

National Provider Directory
Tax ID family
Diagnostic Laboratory O14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

Locations

1001 Cornell Pkwy
Oklahoma City, OK 73108
Phone (405) 945-0877

3000 United Founders Blvd
Ste 141
Oklahoma City, OK 73112
Phone (405) 607-4020

3366 N West Expy
Ste 150
Oklahoma City, OK 73112
Phone (405) 945-4560

5911 W Memorial Rd
Oklahoma City, OK 73142
Phone (405) 773-6400

1133 S Utica Ave
Ste G162
Tulsa, OK 74104
Phone (918) 294-5300

1145 S Utica Ave
Ste G162
Tulsa, OK 74104
Phone (918) 294-5356

8321 E 61st St
Ste 108
Tulsa, OK 74133
Phone (918) 294-5300

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1390521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759276800000",
    "number": "1285057455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14275 MIDWAY RD STE 400",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750013661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 NW EXPRESSWAY",
            "address_2": "HLA LABORATORY 2ND FLOOR #2259",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731124462",
            "telephone_number": "405-713-7002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAGNOSTIC LABORATORY OF OKLAHOMA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-24",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A",
        "authorized_official_last_name": "MULLEN",
        "authorized_official_first_name": "R'NEE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "405-608-6290"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "OK",
            "license": "37D2068295",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100758750A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Transplant Immunology Laboratory",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Transplant Immunology Laboratory",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.